Difference between revisions of "Adrenocortical Carcinoma"

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m (Adrenal gland tumors, adrenocortical carcinoma - adjuvant therapy)
(Adrenal gland tumors, adrenocortical carcinoma - adjuvant therapy)
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'''2 to 3-year course'''
 
'''2 to 3-year course'''
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===Regimen #2, Haak et al. 1994===
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Level of Evidence:
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<span
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style="background:#EEEE00;
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padding:3px 6px 3px 6px;
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border-style:solid;">Phase II</span>
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''Haak et al. 1994 concluded that "mitotane treatment in adrenocortical carcinoma is effective only when high
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serum levels [trough of at least 14 mg/L] can be achieved."''
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*[[Mitotane (Lysodren)]] 1000 to 2000 mg PO QID (total dose per day: 4000 to 8000 mg), with target mitotane trough of above 14 mg/L
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'''2-year course "if resection was judged to be complete or for 1 year after apparent disappearance of the tumour"'''
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Supportive medications:
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*Hydrocortisone (Cortef) 30 to 120 mg per day or Fludrocortisone (Florinef) 0.1 to 0.4 mg per day
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*Metoclopramide (Reglan) and Loperamide (Imodium) prn "gastrointestinal side-effects"

Revision as of 02:44, 30 October 2013

Adrenal gland tumors, adrenocortical carcinoma - adjuvant therapy

Mitotane (Lysodren)

There is limited and controversial clinical trial information about adjuvant mitotane use. See the references for additional case series and expert recommendation articles.

Regimen #1, Wängberg et al. 2010

Level of Evidence: Phase II

Patients started on adjuvant mitotane within 4 weeks of their surgical resection.

  • Mitotane (Lysodren) 2000 mg PO per day (frequency not specified, such as whether the total daily dose was divided into a few doses throughout the day); within the first 2 to 3 months, Mitotane (Lysodren) dose was adjusted to achieve a target therapeutic drug level of 14 to 20 mg/L

2 to 3-year course

Regimen #2, Haak et al. 1994

Level of Evidence: Phase II

Haak et al. 1994 concluded that "mitotane treatment in adrenocortical carcinoma is effective only when high serum levels [trough of at least 14 mg/L] can be achieved."

  • Mitotane (Lysodren) 1000 to 2000 mg PO QID (total dose per day: 4000 to 8000 mg), with target mitotane trough of above 14 mg/L

2-year course "if resection was judged to be complete or for 1 year after apparent disappearance of the tumour"

Supportive medications:

  • Hydrocortisone (Cortef) 30 to 120 mg per day or Fludrocortisone (Florinef) 0.1 to 0.4 mg per day
  • Metoclopramide (Reglan) and Loperamide (Imodium) prn "gastrointestinal side-effects"