Hostname: page-component-848d4c4894-tn8tq Total loading time: 0 Render date: 2024-06-24T16:46:17.406Z Has data issue: false hasContentIssue false
  • English
  • Français

Trimodality approach, using modern radiation techniques, for management of locally advanced adrenocortical carcinoma – case report

Published online by Cambridge University Press:  18 August 2021

André Laranja Open the ORCID record for André Laranja [Opens in a new window]  and
Carolina Ferreira
André Laranja*
Affiliation:
Department of External Radiotherapy, Instituto Português de Oncologia do Porto Francisco Gentil, EPE, Porto, Portugal
Carolina Ferreira
Affiliation:
Department of External Radiotherapy, Instituto Português de Oncologia do Porto Francisco Gentil, EPE, Porto, Portugal
*
Author for correspondence: Carlos André de Neves Laranja, Instituto Português de Oncologia do Porto Francisco Gentil, EPE, Department of External Radiotherapy, Rua Dr. António Bernardino de Almeida, Porto, 4200-072, Portugal. Tel: +351915477785. E-mails: andrelaranja79@hotmail.com; andre.laranja@ipoporto.min-saude.pt
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy. Surgery is the mainstay of treatment, still even after a R0 surgical margins, there is a high risk of recurrence.

Case Presentation:

A 26-year-old female diagnosed with a large functioning ACC treated with a trimodality approach (surgery, radiotherapy and chemotherapy). Postoperative radiotherapy was proposed regarding the high risk of recurrence. A dose of 50.4 Gy in 28 fractions was delivered to the patient using a volumetric-modulated arc therapy plan. Radiotherapy was safe and well tolerated, and no local recurrence was observed so far (13 months after radiotherapy).

Conclusions:

Due to the rarity of ACC and the lack of evidence regarding this entity, therapeutic approach can be challenging. Recent evidence suggests that radiotherapy could have an important role in the therapeutic arsenal.

Keywords

adrenocorticaladjuvant treatmentcarcinomaradiotherapy
Type
Case Study
Information
Journal of Radiotherapy in Practice , Volume 22 , 2023 , e14
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rossella, L. Adrenocortical carcinoma (ACC): diagnosis, prognosis, and treatment. Front Cell Dev Biol 2015; 3: 45.Google Scholar
Ammu, T, Ekta, S, Ghada, E, Ricardo, C. Adrenocortical carcinoma: a literature review. Translational Cancer Research 2019; 9 (2): 1253–1264.Google Scholar
Sara, B, Marilyne, D, Lina, A, Mouhammed, A H. Adjuvant therapy in adrenocortical carcinoma: reflections and future directions. Cancers (Basel) 2020; 12 (2): 508.Google Scholar
Martin, F, Olaf, D, Tobias, El et al. European Society of Endocrinology Clinical Practice Guidelines on the management of adrenocortical carcinoma in adults, in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol 2018; 179 (4): G1–G46.Google Scholar
Margonis, G, Kim, Y, Prescott, J et al. Adrenocortical carcinoma: impact of surgical margin status on long-term outcomes. Ann Surg Oncol 2016; 23 (1): 134–141.CrossRefGoogle ScholarPubMed
Fassnacht, M, Assie, G, Baudie, E et al. Adrenocortical carcinomas and malignant phaeochromocytomas: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2020; 31 (11): 1476–1490.CrossRefGoogle ScholarPubMed
Gustavo, V, Bruno, V. Adjuvant radiotherapy after surgical resection for adrenocortical carcinoma: A systematic review of observational studies and meta-analysis. J Cancer Res Ther 2019; 15: S20–S26.Google Scholar
Srougi, V, Junior, J, Tanno, F et al. Adjuvant radiotherapy for the primary treatment of adrenocortical carcinoma: are we offering the best? Int Braz J Urol 2017; 43 (5): 841–848.CrossRefGoogle ScholarPubMed
Jiawei, Z, Ziye, Z, Jing, S. Efficacy of adjuvant radiotherapy for treatment of adrenocortical carcinoma: a retrospective study and an updated meta-analysis. Radiat Oncol 2020; 15 (1): 118.Google Scholar
Gharzai, L, Green, M, Griffith, K et al. Adjuvant radiation improves recurrence-free survival and overall survival in adrenocortical carcinoma. J Clin Endocrinol Metab 2019; 104 (9): 3743–3750.CrossRefGoogle ScholarPubMed
National Comprehensive Cancer Network. Neuroendocrine and Adrenal Tumors (Version 2.2021). https://www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf. Accessed 15 July 2021Google Scholar
Fassnacht, M, Hahner, S, Polat, B et al. Efficacy of adjuvant radiotherapy of the tumor bed on local recurrence of adrenocortical carcinoma. J Clin Endocrinol Metab 2006; 91 (11): 4501–4504.CrossRefGoogle ScholarPubMed
Habra, M, Ejaz, S, Feng, L et al. A retrospective cohort analysis of the efficacy of adjuvant radiotherapy after primary surgical resection in patients with adrenocortical carcinoma. J Clin Endocrinol Metab 2013; 98 (1): 192–197.CrossRefGoogle ScholarPubMed
Sabolch, A, Else, T, Griffith, K et al. Adjuvant radiation therapy improves local control after surgical resection in patients with localized adrenocortical carcinoma. Int J Radiat Oncol Biol Phys 2015; 92 (2): 252–259.CrossRefGoogle ScholarPubMed
Zhu, J, Zheng, Z, Shen, J et al. Efficacy of adjuvant radiotherapy for treatment of adrenocortical carcinoma: a retrospective study and an updated meta-analysis. Radiat Oncol 2020; 15 (1): 118.CrossRefGoogle Scholar