Topics:
Lung Cancer • Radiation Oncology • Thoracic Malignancies • Non-small cell lung cancer • Stage IV
Would you deliver SBRT to the adrenal gland if a patient has already undergone contralateral adrenalectomy for oligometastatic NSCLC?
What would you anticipate with regard to potential adrenal toxicity when the patient has only 1 functioning adrenal gland? There are no other sites of metastatic or active disease.
Answer from: Radiation Oncologist at Academic Institution
I have treated one patient in a similar scenario, with bilateral adrenal metastases. I referred the patient to endocrinology for counseling about the need for future adrenal hormone replacement, and after thoroughly discussing these implications with the patient, we proceeded. This is of course an e...
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Answer from: Radiation Oncologist at Academic Institution
I similarly have treated 1 such patient. He had only one adrenal gland/kidney and a met at the adrenal gland. After a well informed discussion we proceeded with SBRT to the adrenal met. I sent the patient for an Endocrinology consult. I also continued to follow him for a year and much to my surprise...
Comments
Radiation Oncologist at Stanford University
I have a similar anecdote to share. Endocrinology ...
I have a similar anecdote to share. Endocrinology ...
Answer from: Radiation Oncologist at Academic Institution
Yes, but keep endocrine in the loop. I have also treated bilateral adrenals with SABR. Just need endocrine to keep an eye on the cortisol level.