Role of radiotherapy in adrenocortical carcinoma.

摘要: Purpose Adrenocortical carcinoma (ACC) is a rare and highly malignant tumor usually diagnosed in an advanced stage. Radiation therapy has been poorly studied underutilized therapeutic option. Methods This retrospective analysis reviewed treatment courses for 14 patients with pathologically confirmed ACC treated between 1997 2012. Two were adjuvantly following surgery, 12 palliative intent. Patients presented stage II (n = 4), III 7), IV 3) disease. had mean age of 51.5 years. Ten received chemotherapy before radiotherapy (RT), surgery RT, receiving radiation at 17.8 months after diagnosis. Results In total, 20 sites treated, 2 which adjuvant setting, 18 indications as follows: (1) pain/neuropathy 10), (2) prophylactic asymptomatic recurrences 3), (3) prevention imminent metastatic complications 2), hemoptysis 1), severe mass effect brain metastasis 1). Sites to median dose 36.3 Gy (range, 17.5-60 Gy) 2.5 Gy/fraction 1.8-4 Gy). At follow-up 22.0 the given 1 patient did not have local recurrence during 14.3-month period follow-up, other 14.5 RT. 11.3 10 either clinical or radiographic response. Of RT that adequate 4 treatments (27%) resulted partial Eleven (73%) able be evaluated improvement. Acute Therapy Oncology Group/European Organization Research Treatment Cancer toxicities observed 7 included 3 grade 1, 2, 3. No acute toxicity greater any late greater. Discussion report one largest date examining role modern techniques management ACC. We conclude can effective ACC, palliating symptoms, preventing from large metastases. should considered option multimodality patients.