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Cited by 259Adrenal and Paraganglionic TumorsRenal cell carcinoma treatmentAdrenal Hormones and Disorders

Efficacy of adjuvant radiotherapy of the tumor bed on local recurrence of adrenocortical carcinoma

Fassnacht, Martin, Hahner, Stefanie, Polat, Buelent, Koschker, Ann-Cathrin, Kenn, Werner, Flentje, Michael, Allolio, Bruno·2006·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2006-1007
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Abstract

CONTEXT: Local tumor recurrence is common in adrenocortical carcinoma (ACC) and is the most frequent cause for reoperation. Although radiotherapy is often considered ineffective in the treatment of ACC, the limited number of available studies does not support this statement. OBJECTIVE: The objective of the study was investigation of adjuvant tumor bed irradiation in the treatment of ACC. DESIGN: We performed a retrospective analysis. PATIENTS: The German ACC Registry (n = 285) was screened for patients who had received tumor bed radiotherapy in an adjuvant setting (no macroscopic evidence for residual disease after surgery). Fourteen patients without distant metastases (World Health Organization stage I, one patient; stage II, seven; stage III, three; and stage IV, three) were matched with 14 patients for resection status, adjuvant mitotane treatment, stage, and tumor size. Median follow-up of patients still alive (n = 15) was 37 months. MAIN OUTCOME MEASURE: Survival without local recurrence and disease-free survival was the main outcome measure. RESULTS: Local recurrence was observed in two of 14 patients in the radiotherapy group and in 11 of 14 control patients. The probability to be free of local recurrence 5 yr after surgery differed significantly [79% (95% confidence interval, 53-100) vs. 12% (0-30); P < 0.01]. However, disease-free and overall survival were not significantly different between the two groups. Acute adverse events related to radiotherapy were mostly mild. One patient developed a partial Budd-Chiari syndrome. CONCLUSION: These data from the largest series of ACC patients treated with adjuvant tumor bed irradiation suggest that radiotherapy is effective in reducing the high rate of local recurrence in ACC. A randomized trial in high-risk patients is needed to further evaluate the efficacy of radiotherapy as an adjuvant treatment option in ACC.

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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 [332]

  • In Fassnacht et al, radiotherapy after complete resection in 14 patients with nonmetastatic ACC did not improve survival but significantly improved local control; at 5 years, local recurrence-free survival was 86% in the radiation group vs 11% in those who did not receive radiation.

    “Although radiotherapy did not improve survival, it did significantly improve local control: at 5 years, local recurrence-free survival was 86% in the group that received radiation compared with 11% in those that did not (332).”

    From Adrenocortical carcinoma (2014) · cites this paper as [332]

  • In Habra et al, local recurrence rate for patients receiving adjuvant radiotherapy after surgery was 44%, compared with 14% in Fassnacht et al and 20% in Sabolch et al.

    “More specifically, although Habra et al (338) found a local recurrence rate of 44% for such patients, Fassnacht et al (332) showed a 14% local failure rate and Sabolch et al (247) found a 20% rate.”

    From Adrenocortical carcinoma (2014) · cites this paper as [332]

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Authors
Fassnacht, M., Hahner, S., Polat, B., Koschker, A.-C., Kenn, W., Flentje, M., & Allolio, B.
Affiliations
  • University of Würzburg (DE)
  • Department of Radiation Oncology (B.P., M.Fl.), 97080 Wuerzburg, Germany
  • Universitätsklinikum Würzburg (DE)
Corresponding author
Fassnacht, Martin
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2006-11-01
Volume
91
Issue
11
Pages
4501-4504
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2006-1007
OpenAlex
W2080838501
Cited by
259
References
19
Citations by year
2026: 6 · 2025: 8 · 2024: 11 · 2023: 9 · 2022: 10 · 2021: 14 · 2020: 14 · 2019: 12 · 2018: 18 · 2017: 13 · 2016: 7 · 2015: 22 · 2014: 18 · 2013: 14 · 2012: 14
FWCI
13.26
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • European Commission
  • Deutsche Krebshilfe
Topics
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal cell carcinoma treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
adrenocortical carcinoma, adjuvant radiotherapy, tumor bed irradiation, local recurrence, disease-free survival, overall survival, mitotane, reoperation
MeSH terms
Adrenal Cortex Neoplasms, Adult, Combined Modality Therapy, Humans, Middle Aged, Mitotane, Neoplasm Recurrence, Local, Radiotherapy, Retrospective Studies, Survival Analysis, Treatment Outcome, Chemotherapy, Adjuvant, Adrenocortical Carcinoma, Disease-Free Survival, Radiotherapy, Adjuvant, Antineoplastic Agents, Hormonal

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