Adrenocortical carcinoma radiation therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Mohammed Abdelwahed M.D [3]

Overview

Radiation therapy and radiofrequency ablation may be used for palliation in patients who are not surgical candidates. Recurrence is lower in patients with adjuvant radiotherapy than in patients without radiotherapy. ACC with metastasis to bone experienced adequate pain relief after radiotherapy.

Radiotherapy has shown improvement in both the adjuvant and palliative ACCs.

According to the National Cancer Data Base and the surveillance, epidemiology, and end results program, there is an evidence that radiotherapy might be effective.^[1]
Local recurrence-free survival was 86% in the group that received radiation compared with 11% in those that did not.^[2]
Radiotherapy also can be used for treating unresectable masses.^[3]

77% of patients with metastatic ACCs to bone experienced adequate palliation of pain after radiotherapy with dosages totaling 10 to 60 Gyger.^[4]
Radiofrequency ablation (RFA) and transarterial chemoembolization are alternatives to surgery when surgery is not desired or contraindicated.
High local tumor regression can be achieved with minimal systemic side effects.^[5]
Bleeding is one of the complications as adrenal tumors have a tendency to undergo hemorrhage.^[6]

↑ Paton BL, Novitsky YW, Zerey M, Harrell AG, Norton HJ, Asbun H; et al. (2006). “Outcomes of adrenal cortical carcinoma in the United States”. Surgery. 140 (6): 914–20, discussion 919-20. doi:10.1016/j.surg.2006.07.035. PMID 17188138.
↑ Fassnacht M, Hahner S, Polat B, Koschker AC, Kenn W, Flentje M; et al. (2006). “Efficacy of adjuvant radiotherapy of the tumor bed on local recurrence of adrenocortical carcinoma”. J Clin Endocrinol Metab. 91 (11): 4501–4. doi:10.1210/jc.2006-1007. PMID 16895957.
↑ Sabolch A, Feng M, Griffith K, Hammer G, Doherty G, Ben-Josef E (2011). “Adjuvant and definitive radiotherapy for adrenocortical carcinoma”. Int J Radiat Oncol Biol Phys. 80 (5): 1477–84. doi:10.1016/j.ijrobp.2010.04.030. PMID 20675074.
↑ Markoe AM, Serber W, Micaily B, Brady LW (1991). “Radiation therapy for adjunctive treatment of adrenal cortical carcinoma”. Am J Clin Oncol. 14 (2): 170–4. PMID 1709336.
↑ Thacker PG, Friese JL, Loe M, Biegler P, Larson M, Andrews J (2009). “Embolization of nonliver visceral tumors”. Semin Intervent Radiol. 26 (3): 262–9. doi:10.1055/s-0029-1225667. PMC 3036499. PMID 21326571.
↑ de Baere T, Teriitehau C, Deschamps F, Catherine L, Rao P, Hakime A; et al. (2010). “Predictive factors for hypertrophy of the future remnant liver after selective portal vein embolization”. Ann Surg Oncol. 17 (8): 2081–9. doi:10.1245/s10434-010-0979-2. PMID 20237856.