Radiotherapy in adrenocortical carcinoma
Open accessAbstract
Adrenocortical carcinoma (ACC) is a rare malignancy, and patients with ACC have a poor prognosis. Even after radical surgery, up to 85% of patients develop recurrent disease. Systemic treatment options still have limited efficacy. Because the role of radiotherapy is not defined well and because ACC often is considered radioresistant, the authors reviewed the available data on radiotherapy for ACC. Original articles and reviews were identified using a PubMed search strategy that included the period up to July 2008. Ten articles were identified that covered radiotherapy in a total of 129 patients with ACC (64 patients received postoperative irradiation, and 65 patients received palliative therapy for advanced disease). In addition, 26 patients were identified in the German ACC Registry who received palliative radiotherapy. Furthermore, patterns of failure after adjuvant radiotherapy were investigated, and the authors provided recommendations for patient selection, treatment planning, and treatment protocols. In an adjuvant setting, postoperative radiotherapy was able to prevent local recurrence in the majority of patients. In those with advanced disease, a response to radiotherapy was observed in 57% of patients who received palliative radiotherapy. Therefore, the authors concluded that radiotherapy may play an important role in the care of patients with ACC. Until better evidence is available, the authors recommended the following approach: Adjuvant radiotherapy to the tumor bed should be considered in patients at high risk for local recurrence (eg, incomplete/R1 resection); a total dose of >40 grays (Gy) with single fractions of 1.8 Gy to 2 Gy should be administered (including a boost volume to reach from 50 Gy to 60 Gy in individual patients); and radiotherapy in a palliative setting may be used for symptomatic metastases to bone, brain, or vena cava obstruction. With state-of-the-art technology, acute and long-term toxicities mostly were mild to moderate. However, the authors concluded that prospective investigations would be required to fully define the therapeutic potential of this important treatment option.
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Radiotherapy has been shown in several recent series to offer a significant improvement in disease control in both adjuvant and palliative settings, although such improvement has not been universally demonstrated.
“Although traditionally considered ineffective for ACC (327–331), radiotherapy has been shown in several recent series to offer a significant improvement in disease control in both the adjuvant and palliative settings (247, 332–337), although such an improvement has not been universally demonstrated (338).”
From Adrenocortical carcinoma (2014) · cites this paper as [336]
Polat et al reported 22 patients with painful osseous metastases, 17 (77%) experienced adequate palliation of pain after radiotherapy with dosages totaling 10 to 60 Gy.
“In this series, 22 patients had painful osseous metastases, and 17 patients (77%) experienced adequate palliation of pain after radiotherapy with dosages totaling 10 to 60 Gy.”
From Adrenocortical carcinoma (2014) · cites this paper as [336]
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Self-citation
- Authors
- Polat, B., Fassnacht, M., Pfreundner, L., Guckenberger, M., Bratengeier, K., Johanssen, S., Kenn, W., Hahner, S., Allolio, B., & Flentje, M.
- Affiliations
- University of Würzburg (DE)
- Venue
- Cancer
- Publisher
- Wiley
- Published
- 2009-04-28
- Volume
- 115
- Issue
- 13
- Pages
- 2816-2823
- ISSN
- 0008-543X (ISSN-L)
- 1097-0142
- OpenAlex
- W2050111607
- Cited by
- 189
- References
- 43
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 6 · 2023: 9 · 2022: 11 · 2021: 18 · 2020: 13 · 2019: 7 · 2018: 15 · 2017: 7 · 2016: 6 · 2015: 19 · 2014: 9 · 2013: 12 · 2012: 20
- FWCI
- 16.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cancer (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Sarcoma Diagnosis and Treatment
- Keywords
- adrenocortical carcinoma, radiotherapy, adjuvant radiotherapy, postoperative radiotherapy, palliative radiotherapy, local recurrence, incomplete resection, metastasis, vena cava obstruction, radioresistance (biology), treatment toxicity, dose fractionation
- MeSH terms
- Adrenal Cortex Neoplasms, Combined Modality Therapy, Humans, Lymphatic Metastasis, Neoplasm Recurrence, Local, Palliative Care, Radiation Injuries, Recurrence, Treatment Outcome, Adrenocortical Carcinoma, Radiotherapy, Adjuvant
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