Efficacy and safety of radiation therapy in advanced adrenocortical carcinoma

Otilia Kimpel; Paul Schindler; Laura Schmidt-Pennington; Barbara Altieri; Felix Megerle; Harm Haak; James Pittaway; Ulrich Dischinger; Marcus Quinkler; Knut Mai; Matthias Kroiss; Bülent Polat; Martin Fassnacht

doi:10.1038/s41416-022-02082-0

Efficacy and safety of radiation therapy in advanced adrenocortical carcinoma

Otilia Kimpel, Paul Schindler, Laura Schmidt-Pennington, Barbara Altieri, Felix Megerle, Harm Haak, James Pittaway, Ulrich Dischinger, Marcus Quinkler, Knut Mai, Matthias Kroiss, Bülent Polat, Martin Fassnacht^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: International guidelines emphasise the role of radiotherapy (RT) for the management of advanced adrenocortical carcinoma (ACC). However, the evidence for this recommendation is very low.

METHODS: We retrospectively analysed all patients who received RT for advanced ACC in five European centres since 2000.

PRIMARY ENDPOINT: time to progression of the treated lesion (tTTP). Secondary endpoints: best objective response, progression-free survival (PFS), overall survival (OS), adverse events, and the establishment of predictive factors by Cox analyses.

RESULTS: In total, 132 tumoural lesions of 80 patients were treated with conventional RT (cRT) of 50-60 Gy (n = 20) or 20-49 Gy (n = 69), stereotactic body RT of 35-50 Gy (SBRT) (n = 36), or brachytherapy of 12-25 Gy (BT) (n = 7). Best objective lesional response was complete (n = 6), partial (n = 52), stable disease (n = 60), progressive disease (n = 14). Median tTTP was 7.6 months (1.0-148.6). In comparison to cRT20-49Gy, tTTP was significantly longer for cRT50-60Gy (multivariate adjusted HR 0.10; 95% CI 0.03-0.33; p < 0.001) and SBRT (HR 0.31; 95% CI 0.12-0.80; p = 0.016), but not for BT (HR 0.66; 95% CI 0.22-1.99; p = 0.46). Toxicity was generally mild and moderate with three grade 3 events. No convincing predictive factors could be established.

CONCLUSIONS: This largest published study on RT in advanced ACC provides clear evidence that RT is effective in ACC.

Original language	English
Pages (from-to)	586-593
Number of pages	8
Journal	British Journal of Cancer
Volume	128
Issue number	4
Early online date	8 Dec 2022
DOIs	https://doi.org/10.1038/s41416-022-02082-0
Publication status	Published - 16 Feb 2023

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Cite this

@article{99be27ac41e14245806978d48f52cb9b,

title = "Efficacy and safety of radiation therapy in advanced adrenocortical carcinoma",

abstract = "BACKGROUND: International guidelines emphasise the role of radiotherapy (RT) for the management of advanced adrenocortical carcinoma (ACC). However, the evidence for this recommendation is very low.METHODS: We retrospectively analysed all patients who received RT for advanced ACC in five European centres since 2000.PRIMARY ENDPOINT: time to progression of the treated lesion (tTTP). Secondary endpoints: best objective response, progression-free survival (PFS), overall survival (OS), adverse events, and the establishment of predictive factors by Cox analyses.RESULTS: In total, 132 tumoural lesions of 80 patients were treated with conventional RT (cRT) of 50-60 Gy (n = 20) or 20-49 Gy (n = 69), stereotactic body RT of 35-50 Gy (SBRT) (n = 36), or brachytherapy of 12-25 Gy (BT) (n = 7). Best objective lesional response was complete (n = 6), partial (n = 52), stable disease (n = 60), progressive disease (n = 14). Median tTTP was 7.6 months (1.0-148.6). In comparison to cRT20-49Gy, tTTP was significantly longer for cRT50-60Gy (multivariate adjusted HR 0.10; 95% CI 0.03-0.33; p < 0.001) and SBRT (HR 0.31; 95% CI 0.12-0.80; p = 0.016), but not for BT (HR 0.66; 95% CI 0.22-1.99; p = 0.46). Toxicity was generally mild and moderate with three grade 3 events. No convincing predictive factors could be established.CONCLUSIONS: This largest published study on RT in advanced ACC provides clear evidence that RT is effective in ACC.",

author = "Otilia Kimpel and Paul Schindler and Laura Schmidt-Pennington and Barbara Altieri and Felix Megerle and Harm Haak and James Pittaway and Ulrich Dischinger and Marcus Quinkler and Knut Mai and Matthias Kroiss and B{\"u}lent Polat and Martin Fassnacht",

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doi = "10.1038/s41416-022-02082-0",

language = "English",

volume = "128",

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journal = "British Journal of Cancer",

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TY - JOUR

T1 - Efficacy and safety of radiation therapy in advanced adrenocortical carcinoma

AU - Kimpel, Otilia

AU - Schindler, Paul

AU - Schmidt-Pennington, Laura

AU - Altieri, Barbara

AU - Megerle, Felix

AU - Haak, Harm

AU - Pittaway, James

AU - Dischinger, Ulrich

AU - Quinkler, Marcus

AU - Mai, Knut

AU - Kroiss, Matthias

AU - Polat, Bülent

AU - Fassnacht, Martin

PY - 2023/2/16

Y1 - 2023/2/16

N2 - BACKGROUND: International guidelines emphasise the role of radiotherapy (RT) for the management of advanced adrenocortical carcinoma (ACC). However, the evidence for this recommendation is very low.METHODS: We retrospectively analysed all patients who received RT for advanced ACC in five European centres since 2000.PRIMARY ENDPOINT: time to progression of the treated lesion (tTTP). Secondary endpoints: best objective response, progression-free survival (PFS), overall survival (OS), adverse events, and the establishment of predictive factors by Cox analyses.RESULTS: In total, 132 tumoural lesions of 80 patients were treated with conventional RT (cRT) of 50-60 Gy (n = 20) or 20-49 Gy (n = 69), stereotactic body RT of 35-50 Gy (SBRT) (n = 36), or brachytherapy of 12-25 Gy (BT) (n = 7). Best objective lesional response was complete (n = 6), partial (n = 52), stable disease (n = 60), progressive disease (n = 14). Median tTTP was 7.6 months (1.0-148.6). In comparison to cRT20-49Gy, tTTP was significantly longer for cRT50-60Gy (multivariate adjusted HR 0.10; 95% CI 0.03-0.33; p < 0.001) and SBRT (HR 0.31; 95% CI 0.12-0.80; p = 0.016), but not for BT (HR 0.66; 95% CI 0.22-1.99; p = 0.46). Toxicity was generally mild and moderate with three grade 3 events. No convincing predictive factors could be established.CONCLUSIONS: This largest published study on RT in advanced ACC provides clear evidence that RT is effective in ACC.

AB - BACKGROUND: International guidelines emphasise the role of radiotherapy (RT) for the management of advanced adrenocortical carcinoma (ACC). However, the evidence for this recommendation is very low.METHODS: We retrospectively analysed all patients who received RT for advanced ACC in five European centres since 2000.PRIMARY ENDPOINT: time to progression of the treated lesion (tTTP). Secondary endpoints: best objective response, progression-free survival (PFS), overall survival (OS), adverse events, and the establishment of predictive factors by Cox analyses.RESULTS: In total, 132 tumoural lesions of 80 patients were treated with conventional RT (cRT) of 50-60 Gy (n = 20) or 20-49 Gy (n = 69), stereotactic body RT of 35-50 Gy (SBRT) (n = 36), or brachytherapy of 12-25 Gy (BT) (n = 7). Best objective lesional response was complete (n = 6), partial (n = 52), stable disease (n = 60), progressive disease (n = 14). Median tTTP was 7.6 months (1.0-148.6). In comparison to cRT20-49Gy, tTTP was significantly longer for cRT50-60Gy (multivariate adjusted HR 0.10; 95% CI 0.03-0.33; p < 0.001) and SBRT (HR 0.31; 95% CI 0.12-0.80; p = 0.016), but not for BT (HR 0.66; 95% CI 0.22-1.99; p = 0.46). Toxicity was generally mild and moderate with three grade 3 events. No convincing predictive factors could be established.CONCLUSIONS: This largest published study on RT in advanced ACC provides clear evidence that RT is effective in ACC.

U2 - 10.1038/s41416-022-02082-0

DO - 10.1038/s41416-022-02082-0

M3 - Article

C2 - 36482186

SN - 0007-0920

VL - 128

SP - 586

EP - 593

JO - British Journal of Cancer

JF - British Journal of Cancer

IS - 4

ER -