EYES2022 ESE Young Endocrinologists and Scientists (EYES) 2022 Endocrine-related Cancer (11 abstracts)
Efficacy and safety of radiation therapy in advanced adrenocortical carcinoma (ACC)
Kimpel O 1 , Schindler P 1 , Schmidt-Pennington L 8 , Altieri B 1 , Megerle F 1 , Steenaard R 6 , Pittaway J 5 , Quinkler M 7 , Mai K 8 , Kroiss M. 1,2,3 , Polat B 4 & Fassnacht M. & 2
1University Hospital, University of Würzburg, Division of Endocrinology and Diabetes, Department of Medicine; 2University of Würzburg, Comprehensive Cancer Center Mainfranken; 3University Hospital, LMU Munich, Department of Medicine IV; 4University of Würzburg, Department of Radiation Oncology; 5Queen Mary University of London, Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry; 6Máxima MC, Eindhoven/Veldhoven, the Netherlands. Maastricht University, Caphri School for Public Health and Primary Care, Ageing and Long-Term Care, Department of Internal Medicine; 7Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Endocrinology & Metabolism; 8 Charité - Universitätsmedizin Berlin, Department of Endocrinology & Metabolism
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.
Objectives: The aim of this study was to retrospectively investigate the efficacy and tolerance of RT 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 (oPFS, overall survival (OS), toxicity of the treatment, analysis of predictive factors. In addition, we analyzed patients according the equivalent dose in 2 Gy fractions (EQD2) and the biologically effective dose (BED10).
Results: 132 tumoral lesions in 80 patients were identified. They were treated with various RT modalities (stereotactic body RT (SBRT) 35-50Gy (n=36), ‘non-SBRT’ with 50-60 Gy (n=20) or with 20-49 Gy (n=69), ‘single dose RT’ (SDRT) 12-25Gy (n=7)). Complete response was detected in 6 lesions. 52 metastases showed partial response, 60 were stable and only 14 lesions progressive. In comparison to non-SBRT with 50-60 Gy, tPFS was significantly shorter in non-SBRT with 20-49Gy (multivariate adjusted HR 5.9; 95% CI 1.89-18.9;P = 0.002) and in SDRT (HR 4.8; 95% CI 1.13-20.71;P = 0.033), but quite similar as to SBRT (HR 1.8; 95% CI 0.54-6.04;P = 0.34). The examination with EQD2 and BED10 indicated similar results. Toxicities with grade 3 or higher did not occur.ConclusionsOur study provides for the first time evidence from a larger cohort that RT is effective in a proportion of patients with advanced ACC. The retrospective nature and the size of the study are major limitations.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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