सीमित मेटास्टेसिस के साथ उन्नत एसीसी: जब स्थानीय थेरेपी और माइटोटेन अपने लक्ष्य तक नहीं पहुंचे तो क्या करें

References

DOI: 10.1530/EJE-18-0608

• For patients presenting at time of initial diagnosis with limited intra-abdominal metastases we suggest surgical therapy if complete resection of all lesions seems feasible (+OOO).
• The panel is convinced that in addition to surgery other local therapeutic measures (e.g. radiation therapy, radiofrequency ablation, cryoablation, microwave ablation, chemoembolization) are of value for therapy of advanced ACC.
• If more aggressive therapy is indicated, then the combination of EDP in addition to mitotane (EDP-M) is the most validated regimen (30).
• In patients unfit for the EDP-M regimen, (E)P-M may constitute a reasonable alternative.
• Plus oral mitotane aiming at a blood level between 14 and 20 mg/L
• In patients who respond to medical therapy (including achievement of long-term stable disease), we suggest re-considering local measures aiming at long-term tumor control.