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Updated: Aug 18, 2025
A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
Efficacy and safety of radiation therapy in advanced adrenocortical carcinoma
Otilia Kimpel1, Paul Schindler1, Laura Schmidt-Pennington2
1Division of Endocrinology and Diabetes, Department of Medicine, University Hospital, University of Würzburg, Würzburg, Germany.
Background:
International guidelines emphasise the role of radiotherapy (RT) for the management of advanced adrenocortical carcinoma (ACC). However, the evidence for this recommendation is very low.
Methods:
We retrospectively analysed all patients who received RT for advanced ACC in five European centres since 2000.
Primary Endpoint:
time to progression of the treated lesion (tTTP). Secondary endpoints: best objective response, progression-free survival (PFS), overall survival (OS), adverse events, and the establishment of predictive factors by Cox analyses.
Results:
In total, 132 tumoural lesions of 80 patients were treated with conventional RT (cRT) of 50-60 Gy (n = 20) or 20-49 Gy (n = 69), stereotactic body RT of 35-50 Gy (SBRT) (n = 36), or brachytherapy of 12-25 Gy (BT) (n = 7). Best objective lesional response was complete (n = 6), partial (n = 52), stable disease (n = 60), progressive disease (n = 14). Median tTTP was 7.6 months (1.0-148.6). In comparison to cRT20-49Gy, tTTP was significantly longer for cRT50-60Gy (multivariate adjusted HR 0.10; 95% CI 0.03-0.33; p < 0.001) and SBRT (HR 0.31; 95% CI 0.12-0.80; p = 0.016), but not for BT (HR 0.66; 95% CI 0.22-1.99; p = 0.46). Toxicity was generally mild and moderate with three grade 3 events. No convincing predictive factors could be established.
Conclusions:
This largest published study on RT in advanced ACC provides clear evidence that RT is effective in ACC.
