Radiotherapy treatment of adrenal gland metastases from hepatocellular carcinoma: clinical features and prognostic factors.

Abstract

BACKGROUND:

The optimal treatment for adrenal metastases from hepatocellular carcinoma (HCC) has not been established. This study analyzed the effects of radiation therapy (RT) for such metastases and identified clinical features and predictors of survival in these patients.

METHODS:

We retrospectively investigated 55 patients with adrenal metastasis from HCC who had been treated with RT. Radiation doses to the adrenal lesions ranged from 26 to 60 Gy, while the intrahepatic lesions were treated by surgical resection, transarterial chemoembolization (TACE), liver transplantation, and/or RT. RT was conducted to adrenal lesions after their intrahepatic lesions were controlled more than 2 months. The parameters studied included survival rates and tumor responses to RT. The Kaplan-Meier method was used to evaluate survival rate and the Cox regression model was used to identify potential predictors of outcome.

RESULTS:

The patients treated by RT had adrenal metastasis on the right side (41), the left (6), or on both sides (8). In all 55 patients, the median survival duration was 13.6 months and there was 100% pain relief after completion of RT. Adverse effects were mild to moderate. Unfavorable pretreatment predictors determined by univariate analysis were associated with multiple intrahepatic foci, metastases to additional organs, high γ-glutamyltransferase and alpha-fetoprotein levels, liver function of Child-Pugh classification B and uncontrolled primary HCC. By multivariate analysis, unfavorable predictors were multiple intrahepatic foci, metastases to additional organs and uncontrolled primary HCC.

CONCLUSIONS:

Radiotherapy as treatment for adrenal metastases in HCC is a good palliative therapy that is associated with reasonable safety. It appears reasonable that such patients should be considered to be treated with radiotherapy. Multiple intrahepatic foci, metastases to additional organs and uncontrolled primary HCC were unfavorable predictors.

• Authors: Le-Yuan Zhou, Zhao-Chong Zeng, Jia Fan, Bing Chen, Sheng-xiang Rao, Jian He, Ping Yang, Jia-zhou Hou, Zhi-feng Wu, Jian-ying Zhang, Yong Hu
• Journal: BMC cancer (BMC Cancer) Vol. 14 Pg. 878 (Nov 25 2014) ISSN: 1471-2407 [Electronic] England
• PMID: 25421498 (Publication Type: Journal Article)

Topics

• Adrenal Gland Neoplasms (radiotherapy, secondary)
• Adult
• Aged
• Aged, 80 and over
• Analysis of Variance
• Carcinoma, Hepatocellular (pathology, radiotherapy)
• Female
• Humans
• Liver Neoplasms (pathology, radiotherapy)
• Male
• Middle Aged
• Prognosis
• Retrospective Studies
• Survival Analysis