ECE2021 Oral Communications Oral Communications 11: Adrenal and Cardiovascular Endocrinoloyg (6 abstracts)
Efficacy and safety of radiation therapy in advanced adrenocortical carcinoma (ACC)
Otilia Kimpel 1 , Schindler Paul 1 , Polat Bülent 2 , Felix Megerle 1 , Harm R. Haak 3 , 4 , 5 , James Pittaway 6 , Marcus Quinkler 7 , Kroiss Matthias 1 , 8 , 9 & Martin Fassnacht 1 & 9
1Division of Endocrinology and Diabetes, Dept. of Medicine, University of Würzburg, Würzburg, Germany; 2Department of Radiation Oncology, University of Würzburg, Würzburg, Germany; 3 Department of Internal Medicine, Division of General Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands.; 4Department of Internal Medicine, Máxima MC, Eindhoven/Veldhoven, the Netherlands; 5CAPHRI School for Public Health and Primary Care, Ageing and Long-Term Care, Maastricht University, Maastricht, the Netherlands; 6Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK; 7Endocrinology in Charlottenburg, 10627 Berlin, Germany; 8Department of Medicine IV, University Hospital, LMU Munich, Ziemssenstraße 1, 80336 München, Germany; 9Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
Background
The ESE-ENSAT guidelines emphasize the role of local therapies and suggest radiotherapy (RT) as an individualized treatment in patients with advanced ACC. However, the evidence for this recommendation is very low. The aim of this study was to retrospectively investigate the efficacy and tolerance of radiation therapy in advanced ACC.
Methods
We screened all patients in five European reference centers for ACC since 2000 for RT of advanced ACC. Primary endpoint was progression-free survival of the treated lesion (tPFS). Secondary endpoints were best objective response, overall progression-free survival, toxicity of the treatment, explorative analysis of predictive factors (e.g. size of lesions, Ki67 of the primary tumor, disease-free interval prior RT or time interval between primary diagnosis and RT).
Results
116 tumoral lesions with a median tumor size of 26 –(7–140) mm (local recurrences (n = 23), metastases in liver (n = 6), lung (n = 33), bone (n = 39), and other regions (n = 15)) in 76 patients (28 male, median age 47.5 (18–78) years) were identified. They were treated with various RT modalities (stereotactic body radiation therapy (SBRT) 35–50Gy (n = 32), ’non-SBRT’ with 50–60 Gy (n = 24) or with 20–49 Gy (n = 55), single dose RT (SDRT) 12–25Gy (n = 5)). Median time between primary diagnosis and start of RT was 34.9 months, median number of therapies (including surgery) before RT was 3(1–17). Complete response was detected in 7 lesions (6%). 47 metastases showed partial response (40.5%), 48 were stable and in only 16 lesions (10%) progression was diagnosed at the first imaging after radiotherapy. Median tPFS was 7.3 (1–148.5) months, whereas overall PFS was 4.4 (1–101) months. At last follow-up, 39 patients were still alive and the median overall survival was 18.5 (2.5–152) months. In comparison to non-SBRT with 50–60 Gy, risk for local recurrence was significantly higher in non-SBRT with 20–49Gy (multivariate adjusted HR 5.1; 95% CI 0.039–0.972; P = 0.046), but quite similar as to SBRT (HR 1.1; 95% 0.18–4.93; P = 0.95) and SDRT (HR 2.2 95% CI 0.11–1.96; P = 0.29). Higher age (P = 0.042) and ki67 index >15 % (P = 0.002) appeared to be important prognostic factors. Toxicities with grade 3 or higher did not occur.
Conclusions
Our study provides for the first time evidence from a larger cohort that radiotherapy is effective in a significant proportion of patients with advanced ACC. The retrospective nature and the size of the study are major limitations.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more