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Title: Adjuvant and Definitive Radiotherapy for Adrenocortical Carcinoma

Purpose: To evaluate the impact of both adjuvant and definitive radiotherapy on local control of adrenocortical carcinoma. Methods and Materials: Outcomes were analyzed from 58 patients with 64 instances of treatment for adrenocortical carcinoma at the University of Michigan's Multidisciplinary Adrenal Cancer Clinic. Thirty-seven of these instances were for primary disease, whereas the remaining 27 were for recurrent disease. Thirty-eight of the treatment regimens involved surgery alone, 10 surgery plus adjuvant radiotherapy, and 16 definitive radiotherapy for unresectable disease. The effects of patient, tumor, and treatment factors were modeled simultaneously using multiple variable Cox proportional hazards regression for associations with local recurrence, distant recurrence, and overall survival. Results: Local failure occurred in 16 of the 38 instances that involved surgery alone, in 2 of the 10 that consisted of surgery plus adjuvant radiotherapy, and in 1 instance of definitive radiotherapy. Lack of radiotherapy use was associated with 4.7 times the risk of local failure compared with treatment regimens that involved radiotherapy (95% confidence interval, 1.2-19.0; p = 0.030). Conclusions: Radiotherapy seems to significantly lower the risk of local recurrence/progression in patients with adrenocortical carcinoma. Adjuvant radiotherapy should be strongly considered after surgical resection.
Authors:
 [1] ;  [2] ;  [3] ;  [4] ;  [5] ;  [2]
  1. University of Michigan Medical School, Ann Arbor, MI (United States)
  2. Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States)
  3. Department of Biostatistics Unit, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI (United States)
  4. Department of Internal Medicine, University of Michigan, Ann Arbor, MI (United States)
  5. Department of Surgery, University of Michigan, Ann Arbor, MI (United States)
Publication Date:
OSTI Identifier:
21587670
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 80; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2010.04.030; PII: S0360-3016(10)00607-3; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ADRENAL GLANDS; CARCINOMAS; HAZARDS; RADIOTHERAPY; SURGERY BODY; DISEASES; ENDOCRINE GLANDS; GLANDS; MEDICINE; NEOPLASMS; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; THERAPY