Difference between revisions of "Adrenocortical Carcinoma"
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'''2 to 3-year course''' | '''2 to 3-year course''' | ||
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| + | ===Regimen #2, Haak et al. 1994=== | ||
| + | Level of Evidence: | ||
| + | <span | ||
| + | style="background:#EEEE00; | ||
| + | padding:3px 6px 3px 6px; | ||
| + | border-color:black; | ||
| + | border-width:2px; | ||
| + | border-style:solid;">Phase II</span> | ||
| + | |||
| + | ''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" | ||
Revision as of 02:44, 30 October 2013
Contents
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"
