Radiotherapy in adrenocortical carcinoma

Area of Science:

• Oncology
• Radiation Oncology

Background:

• Adrenocortical carcinoma (ACC) is a rare cancer with a poor prognosis and high recurrence rates post-surgery.
• Current systemic treatments for ACC have limited efficacy.
• The role and efficacy of radiotherapy in ACC are not well-defined, and it is often considered radioresistant.

Purpose of the Study:

• To review existing data on the use of radiotherapy for adrenocortical carcinoma.
• To evaluate the effectiveness of radiotherapy in both adjuvant and palliative settings for ACC.
• To provide recommendations for radiotherapy use in ACC based on available evidence.

Main Methods:

• A PubMed search was conducted for original articles and reviews on radiotherapy for ACC up to July 2008.
• Data from 129 patients treated with radiotherapy (postoperative or palliative) were analyzed.
• An additional 26 patients receiving palliative radiotherapy from the German ACC Registry were included.

Main Results:

• Postoperative radiotherapy significantly reduced local recurrence rates in the adjuvant setting.
• In advanced ACC, palliative radiotherapy achieved a response in 57% of patients.
• Radiotherapy, particularly with doses >40 Gy, showed potential in managing symptomatic metastases.

Conclusions:

• Radiotherapy may play a significant role in managing adrenocortical carcinoma.
• Adjuvant radiotherapy is recommended for high-risk patients to prevent local recurrence.
• Palliative radiotherapy is a viable option for symptomatic metastases in advanced ACC, with generally mild to moderate toxicity.