An Image-guided SBRT for Adrenal Gland Metastasis in Oligometastatic Patients

A Phase II Trial of Image-guided Stereotactic Body Radiation Therapy (SBRT) for Adrenal Gland Metastasis in Oligometastatic Patients

The study is designed to to assess the efficacy of ablative SBRT delivered with VMAT technique in oligometastatic patients affected by adrenal gland metastases.

This is a phase II, single arm, trial for testing efficacy of ablative high hypofractionated dose delivered with VMAT technique in oligometastatic patients with adrenal gland metastases. The potential advantages of this approach include the possibility to lead an increased local control in irradiated adrenal gland metastases. Other purpose of this study is to assess acute and late toxicity in terms of maintenance of endocrine mechanisms of hormonal production.

Oligometastatic patients with adrenal gland metastases are treated with high dose of Stereotactic Body Radiation Therapy delivered with VMAT/Rapid Arc technique.

The schedule will be 3 fractions of 15 Gy up to a total dose of 45 Gy delivered every day with VMAT and Flattening filter-free (FFF) beams. Image-guided systems, including CBCT, will be used for all patients.

Evaluation of proportion of patients free from progression from starting radiotherapy according to CTCAE v4.03

Assessment acute and late toxicity in terms of maintenance of endocrine mechanisms of hormonal production according to CTCAE v4.03

Inclusion Criteria: Age ≥ 18years. WHO performance status ≤ 1 (ECOG - KPS). Histologically-proven of primary cancer disease Metastases at adrenal gland radiologically proven Written informed consent Exclusion Criteria: Prior radiation to the interested adrenal gland. Patients allergic to contrast used in CT scans or who cannot be premedicated for the use of contrast.