Radiation of bilateral adrenal metastases is associated with a high risk of primary adrenal insufficiency
Authors' conclusion
Patients receiving unilateral adrenal RT with two intact adrenal glands have a low risk of PAI. Patients receiving bilateral adrenal RT have a high risk of PAI and require close monitoring.
Study context
- Population
- Adults with adrenal metastases treated with adrenal radiotherapy (RT), 2010–2021
- Participants
- 56 adults
- Outcome
- Incidence and timeline of PAI after adrenal RT
Methodological detailssingle-centre, longitudinal
- Single-centre
- Longitudinal
Main finding
As reported in the abstract
PAI after adrenal RT · median 6.1 months (IQR 3.9-13.8) after RT
Developed primary adrenal insufficiency (PAI)
8
14.3%
Time to PAI after RT, median (IQR)
6.1 months
3.9–13.8
Observational data: associations, not effects.
Further findings
RT in patients who developed PAI
- RT dose, median (IQR)
- 50 Gy (44-50 Gy)
- Fractions, median (IQR)
- 5 (5-6)
Response of treated metastases (size and/or PET metabolic activity decrease)
- Decreased in size and/or metabolic activity
- 7 patients (87.5%)
Replacement therapy
mg
- Hydrocortisone median daily dose (IQR)
- 20 (18-40)
- Fludrocortisone median daily dose (IQR)
- 0.05 (0.05-0.05 mg)
Deaths (all due to extra-adrenal malignancy) · end of study period
- Died
- 5 patients
- Time since RT, median (IQR)
- 19.7 months (16-21.1 months)
- Time since PAI diagnosis, median (IQR)
- 7.7 months (2.9-12.5 months)
Original publication
Radiation of bilateral adrenal metastases is associated with a high risk of primary adrenal insufficiency. Clin Endocrinol (Oxf). Published 16 March 2023. doi:10.
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