How do you treat adrenal metastases with SBRT?

Do you treat the whole gland or the lesion only?

What is the role of additional imaging (MRI, PET/CT) to delineate disease?

What expansions do you make for CTV and PTV with fiducials or LINAC w/ 4DCT?

Answer from: Radiation Oncologist at Academic Institution

Adrenal glands move quite a bit with breathing. I would strongly recommend some form of motion management, either with breath hold, or 4DCT with abdominal compression, (the latter of which is my personal preference). I draw GTV (just tumor, not entire adrenal gland) as defined on whatever imaging s...

Comments

Radiation Oncologist at Mon Health
Are there any advantages to treating these patient...

Radiation Oncologist at Mayo Clinic School of Medicine
I routinely ask patients to be NPO for 3 hours pri...

Radiation Oncologist at Vanderbilt-Ingram Cancer Center
Depends on the individual patient's anatomy. In so...

Radiation Oncologist at Mon Health
Thank you

Answer from: Radiation Oncologist at Community Practice

Whole gland SBRT with a PTV margin on GTV (we use 5 mm), supine with motion management (LINAC with 4DCT), fuse PET/CT or MRI for tumor delineation, no fiducial markers. In our experience, 36 Gy in 3 fractions works well (Reshko et al., PMID 34277086). Here is a great meta-analysis that shows improve...

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How do you treat adrenal metastases with SBRT?

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