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How would you manage a patient with bilateral adrenal metastases if SBRT is not an option?

What would be an appropriate dose/fractionation scheme for palliation of adrenal metastases from breast cancer if not using SBRT? What are the endocrinologic implications if the patient receives radiation to one adrenal gland now and requires subsequent palliative radiation to the contralateral adrenal gland in the future?
1 Answer
Mednet Member
Mednet Member
Radiation Oncology · Tennessee Oncology
Answered on

Clarifying question: Why isn't SBRT possible? Even for difficult lesions with direct abutment of the duodenum, other small bowel and stomach dose escalation can be accomplished by generating heterogeneous plans that cool off the dose at the OAR interface. I generally prescribe 40-50 Gy/5 fractions, ...

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