TY  - JOUR
A1  - Kimpel, Otilia
A1  - Schindler, Paul
A1  - Schmidt-Pennington, Laura
A1  - Altieri, Barbara
A1  - Megerle, Felix
A1  - Haak, Harm
A1  - Pittaway, James
A1  - Dischinger, Ulrich
A1  - Quinkler, Marcus
A1  - Mai, Knut
A1  - Kroiss, Matthias
A1  - Polat, Bülent
A1  - Fassnacht, Martin
T1  - Efficacy and safety of radiation therapy in advanced adrenocortical carcinoma
JF  - British Journal of Cancer
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 cRT\(_{20-49Gy}\), tTTP was significantly longer for cRT\(_{50-60Gy}\) (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.
KW  - adrenal tumours
KW  - adrenocortical carcinoma (ACC)
KW  - radiotherapy (RT)
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324411
VL  - 128
IS  - 4
ER  - 
TY  - JOUR
A1  - Kimpel, Otilia
A1  - Bedrose, Sara
A1  - Megerle, Felix
A1  - Berruti, Alfredo
A1  - Terzolo, Massimo
A1  - Kroiss, Matthias
A1  - Mai, Knut
A1  - Dekkers, Olaf M.
A1  - Habra, Mouhammed Amir
A1  - Fassnacht, Martin
T1  - Adjuvant platinum-based chemotherapy in radically resected adrenocortical carcinoma: a cohort study
JF  - British Journal of Cancer
N2  - Background
After radical resection, patients with adrenocortical carcinoma (ACC) frequently experience recurrence and, therefore, effective adjuvant treatment is urgently needed. The aim of the study was to investigate the role of adjuvant platinum-based therapy.
Methods
In this retrospective multicentre cohort study, we identified patients treated with adjuvant platinum-based chemotherapy after radical resection and compared them with patients without adjuvant chemotherapy. Recurrence-free and overall survival (RFS/OS) were investigated in a matched group analysis and by applying a propensity score matching using the full control cohort (n = 268). For both approaches, we accounted for immortal time bias.
Results
Of the 31 patients in the platinum cohort (R0 n = 25, RX n = 4, R1 n = 2; ENSAT Stage II n = 11, III n = 16, IV n = 4, median Ki67 30%, mitotane n = 28), 14 experienced recurrence compared to 29 of 31 matched controls (median RFS after the landmark at 3 months 17.3 vs. 7.3 months; adjusted HR 0.19 (95% CI 0.09-0.42; P < 0.001). Using propensity score matching, the HR for RFS was 0.45 (0.29-0.89, P = 0.021) and for OS 0.25 (0.09-0.69; P = 0.007).
Conclusions
Our study provides the first evidence that adjuvant platinum-based chemotherapy may be associated with prolonged recurrence-free and overall survival in patients with ACC and a very high risk for recurrence.
KW  - adjuvant platinum-based chemotherapy
KW  - adrenocortical carcinoma
KW  - radical resection
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-273000
SN  - 1532-1827
VL  - 125
IS  - 9
ER  -