title: Adjuvant and definitive radiotherapy for adrenocortical carcinoma.
abstract: OBJECTIVE
  To evaluate the impact of both adjuvant and definitive radiotherapy on local control of adrenocortical carcinoma.
  
  
  METHODS
  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.affiliation: University of Michigan Medical School, Ann Arbor, MI, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Sabolch
authors.forename: Mary
authors.initials: M
authors.lastname: Feng
authors.forename: Kent
authors.initials: K
authors.lastname: Griffith
authors.forename: Gary
authors.initials: G
authors.lastname: Hammer
authors.forename: Gerard
authors.initials: G
authors.lastname: Doherty
authors.forename: Edgar
authors.initials: E
authors.lastname: Ben-Josef
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000628:therapy; D018268:Adrenocortical Carcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary / Q000628:therapy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002173:Cancer Care Facilities; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000517:prevention & control; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome