Makary MS, Krishner LS, Wuthrick EJ, Bloomston MP, Dowell JD. Yttrium-90 microsphere selective internal radiation therapy for liver metastases following systemic chemotherapy and surgical resection for metastatic adrenocortical carcinoma. World J Clin Oncol 2018; 9(1): 20-25 [PMID: 29468134 DOI: 10.5306/wjco.v9.i1.20]
Corresponding Author of This Article
Mina S Makary, MD, Division of Vascular and Interventional Radiology, Department of Radiology, the Ohio State University Comprehensive Cancer Center, 395 W. 12th Ave, 4th Floor, Columbus, OH 43210, United States. mina.makary@osumc.edu
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Feb 10, 2018; 9(1): 20-25 Published online Feb 10, 2018. doi: 10.5306/wjco.v9.i1.20
Yttrium-90 microsphere selective internal radiation therapy for liver metastases following systemic chemotherapy and surgical resection for metastatic adrenocortical carcinoma
Mina S Makary, Lawrence S Krishner, Evan J Wuthrick, Mark P Bloomston, Joshua D Dowell
Mina S Makary, Joshua D Dowell, Division of Vascular and Interventional Radiology, Department of Radiology, the Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, United States
Lawrence S Krishner, Division of Medical Oncology, Department of Internal Medicine, the Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, United States
Evan J Wuthrick, Department of Radiation Oncology, the Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, United States
Mark P Bloomston, Division of Surgical Oncology, Department of Surgery and James Cancer Hospital and Richard Solove Research Institute, the Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, United States
Author contributions: Makary MS, Krishner LS, Wuthrick EJ, Bloomston MP, and Dowell JD performed the research and analyzed the data; Makary MS and Dowell JD wrote the paper.
Informed consent statement: The study participant provided written informed consent for release of their information and publication of this paper.
Conflict-of-interest statement: The authors confirm that they do not have any conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mina S Makary, MD, Division of Vascular and Interventional Radiology, Department of Radiology, the Ohio State University Comprehensive Cancer Center, 395 W. 12th Ave, 4th Floor, Columbus, OH 43210, United States. mina.makary@osumc.edu
Telephone: +1-614-2938000
Received: September 4, 2017 Peer-review started: September 7, 2017 First decision: October 30, 2017 Revised: November 5, 2017 Accepted: December 4, 2017 Article in press: December 4, 2017 Published online: February 10, 2018 Processing time: 157 Days and 3.5 Hours
Abstract
Adrenocortical carcinoma (ACC) is a rare malignancy with generally poor outcomes and limited treatment options. While surgical resection can be curative for early local disease, most patients present with advanced ACC owing to nonspecific symptoms. For those patients, treatment options include systemic chemotherapy and locoregional therapies including radiofrequency ablation and transarterial chemoembolization. We present the first reported case of utilizing yttrium-90 microsphere selective internal radiation therapy (SIRT) in combination with first line EDP-M (Etoposide, Doxorubicin, Cisplatin, Mitotane) chemotherapy and debulking surgical primary tumor resection for treatment of metastatic ACC. Stable complete radiologic response has been maintained after twelve months with resolution of clinical symptoms. These findings prompt the need for further consideration and studies to elucidate the role of SIRT in combination with systemic and surgical treatment for metastatic ACC.
Core tip: Adrenocortical carcinoma (ACC) is a rare malignancy with generally poor outcomes and limited treatment options. Approximately 70% of ACC patients have unresectable stage III or IV disease on initial presentation. Yttrium-90 microsphere selective internal radiation therapy was applied toward hepatic metastases for a patient with metastatic ACC in combination with first line chemotherapy and debulking surgical primary tumor resection. A stable complete radiologic response has been maintained for twelve months with resolution of clinical symptoms.
