Treatment of Adrenocortical Carcinoma with Bone Metastasis
When adrenocortical carcinoma (ACC) involves bone metastases, management shifts to a specialised strategy targeting skeletal complications and bone-related symptom burden. This page outlines the structured approach for ACC patients with confirmed metastatic bone disease.
Clinical Situation
Adrenocortical carcinoma with bone metastasis defines a distinct clinical scenario requiring dedicated intervention. Metastatic spread to bone in ACC is associated with skeletal-related events and significant pain, making targeted local and systemic strategies essential.
Primary Clinical Goal
The therapeutic aim in this setting is:
Relief of symptoms from bone metastases — control of bone pain
Treatment Approach (Partial Overview)
Management is centred on anti-resorptive therapy alongside appropriate supportive supplementation. Palliative radiation is also incorporated for symptomatic bone lesions. Full agent selection, dosing schedules, and the complete structured regimen are available in the protocol below →
References
DOI: 10.1530/EJE-18-0608
- We recommend therapy with anti-resorptive treatment in patients with bone metastasis.
- The administration of denosumab or bisphosphonates in ‘oncological doses’ in association with calcium intake and vitamin D supplementation are therefore advisable in ACC patients with metastatic bone disease, with the aim to prevent adverse SREs and improve control of bone pain.
- We recommend palliative radiation for symptom palliation in advanced/metastatic ACC patients.
- Two schedules of irradiation are commonly used, which include 8 Gy in a single fraction or 30 Gy in ten fractions.
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