{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T02:03:11Z","timestamp":1780106591745,"version":"3.54.0"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T00:00:00Z","timestamp":1678924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Adrenal metastasis is the most common adrenal malignancy and can be bilateral in up to 43% of patients. Radiotherapy (RT) is one option available to treat adrenal metastases. The risk of primary adrenal insufficiency (PAI) after adrenal RT is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Determine the incidence and the timeline of PAI in patients undergoing adrenal RT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Setting and Participants<\/jats:title><jats:p>Single\u2010centre longitudinal retrospective cohort study of adult patients with adrenal metastases treated with RT between 2010 and 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 56 patients with adrenal metastases treated with adrenal RT, eight (14.3%) patients developed PAI at a median of 6.1 months (interquartile range [IQR]: 3.9\u201313.8) after RT All patients developing PAI had either unilateral RT in the setting of contralateral adrenalectomy or bilateral adrenal RT. Patients who developed PAI received a median RT dose of 50\u2009Gy (IQR: 44\u201350\u2009Gy), administered in a median of five fractions (IQR: 5\u20136). Treated metastases decreased in size and\/or metabolic activity on positron emission tomography in seven patients (87.5%). Patients were initiated on hydrocortisone (median daily dose of 20\u2009mg, IQR: 18\u201340) and fludrocortisone (median daily dose of 0.05\u2009mg, IQR: 0.05\u20130.05\u2009mg). At the end of the study period, five patients died, all due to extra\u2010adrenal malignancy, at a median time of 19.7 months (IQR: 16\u201321.1 months) since RT and median time of 7.7 months (IQR: 2.9\u201312.5 months) since the diagnosis of PAI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14911","type":"journal-article","created":{"date-parts":[[2023,3,11]],"date-time":"2023-03-11T06:18:15Z","timestamp":1678515495000},"page":"35-42","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Radiation of bilateral adrenal metastases is associated with a high risk of primary adrenal insufficiency"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5665-0617","authenticated-orcid":false,"given":"Justine","family":"Herndon","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes and Nutrition Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Hallemeier","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7590-558X","authenticated-orcid":false,"given":"Krishan","family":"Jethwa","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afreen","family":"Shariff","sequence":"additional","affiliation":[{"name":"Division of Endocrinology Duke Health  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9332-2524","authenticated-orcid":false,"given":"Irina","family":"Bancos","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Nutrition Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab512"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(20)30314-4"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14268"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/COC.0b013e3182569189"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33546"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.11.060"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.10.079"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-020-1480-0"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2017.07.011"},{"issue":"3","key":"e_1_2_9_11_1","first-page":"325","article-title":"Stereotactic body radiation therapy (SBRT) of adrenal gland metastases in oligometastatic and oligoprogressive disease","volume":"26","author":"Reshko LB","year":"2021","journal-title":"Rep Pract Oncol Radiother"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.7785\/tcrt.2012.500320"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/0284186X.2011.652738"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2018.05.006"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-64770-2"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2016.09.005"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2018-00092"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-020-07030-w"},{"key":"e_1_2_9_19_1","unstructured":"Services UDoHaH. Common Terminology Criteria for Adverse Events (CTCAE).2017.\u00a0Accessed April 22 2022.https:\/\/ctep.cancer.gov\/protocoldevelopment\/electronic_applications\/docs\/CTCAE_v5_Quick_Reference_5x7.pdf"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.12788"},{"issue":"4","key":"e_1_2_9_21_1","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.3171\/2018.5.JNS18509","article-title":"Hypopituitarism after Gamma Knife radiosurgery for pituitary adenomas: a multicenter, international study","volume":"131","author":"Cordeiro D","year":"2018","journal-title":"J Neurosurg"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncpendmet1051"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1677\/ERC-08-0231"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-021-09045-3"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1679893"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27006"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-022-02028-z"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djz152"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-018-0248-x"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2014.02.004"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2021.100801"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2018.78.1492"},{"key":"e_1_2_9_33_1","volume-title":"Radiotherapy for Pituitary Tumors","author":"Kosmin M","year":"2000"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-018-1737-7"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.14911","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cen.14911","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.14911","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T04:26:00Z","timestamp":1692505560000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.14911"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,16]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1111\/cen.14911"],"URL":"https:\/\/doi.org\/10.1111\/cen.14911","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,16]]},"assertion":[{"value":"2023-01-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}