Lattice radiotherapy for palliation in a case of metastatic adrenocortical carcinoma.

IF 0.5 Q4 ONCOLOGY

International Cancer Conference Journal Pub Date : 2026-02-05 eCollection Date: 2026-04-01 DOI:10.1007/s13691-026-00845-7

N P Jayashree, C Shambhavi, Sumeet Suresh Malapure, Ananth Pai, Naveen Salins, Shirley Lewis

{"title":"Lattice radiotherapy for palliation in a case of metastatic adrenocortical carcinoma.","authors":"N P Jayashree, C Shambhavi, Sumeet Suresh Malapure, Ananth Pai, Naveen Salins, Shirley Lewis","doi":"10.1007/s13691-026-00845-7","DOIUrl":null,"url":null,"abstract":"Adrenocortical carcinoma (ACC) is rare, and metastatic ACC is associated with a poor prognosis. Palliative radiotherapy is valuable in patients with metastatic disease for symptom control. In large tumours, palliative radiotherapy entails large-volume irradiation with homogenous doses, where achieving a good response is uncertain. Lattice Radiotherapy (LRT) is a unique technique where high-dose regions can be achieved within the tumour, providing an edge over factors influencing radio resistance. A 30-year-old lady presented with a mass in the abdomen and was diagnosed with ACC with liver and lung metastases. She received chemotherapy with a palliative intent. Response assessment FDG-PET-CECT after six cycles showed disease progression. She had severe discomfort due to the distended abdomen with a 20 × 16 × 15 cm mass infiltrating the inferior surface of the liver. The patient was planned for palliative radiotherapy with the LRT technique. The entire tumour received 20 Gy in 5 fractions over one week, with high-dose vertices within the tumour receiving 35 Gy in 5 fractions. The treatment plan was generated with the volumetric modulated arc technique (VMAT), and the surrounding normal tissue dose constraints were achieved. At one month after radiotherapy, her symptoms of pain and mass effect were well controlled. The patient experienced grade 1 lower gastrointestinal toxicity that subsided with medication and sustained no grade 3 or 4 toxicity. Response assessment at three months post radiotherapy showed an interval decrease in size and uptake of the right suprarenal lesion, with a drop in standardised uptake value maximum from 11.61 to 3.41. Lattice radiotherapy is a valuable technique for palliation in voluminous tumours. It should be further explored for feasibility and safety to provide better local control and quality of life to patients with large tumours.Supplementary information: The online version contains supplementary material available at 10.1007/s13691-026-00845-7.","PeriodicalId":13703,"journal":{"name":"International Cancer Conference Journal","volume":"15 2","pages":"222-228"},"PeriodicalIF":0.5000,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038755/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Cancer Conference Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s13691-026-00845-7","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/4/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Adrenocortical carcinoma (ACC) is rare, and metastatic ACC is associated with a poor prognosis. Palliative radiotherapy is valuable in patients with metastatic disease for symptom control. In large tumours, palliative radiotherapy entails large-volume irradiation with homogenous doses, where achieving a good response is uncertain. Lattice Radiotherapy (LRT) is a unique technique where high-dose regions can be achieved within the tumour, providing an edge over factors influencing radio resistance. A 30-year-old lady presented with a mass in the abdomen and was diagnosed with ACC with liver and lung metastases. She received chemotherapy with a palliative intent. Response assessment FDG-PET-CECT after six cycles showed disease progression. She had severe discomfort due to the distended abdomen with a 20 × 16 × 15 cm mass infiltrating the inferior surface of the liver. The patient was planned for palliative radiotherapy with the LRT technique. The entire tumour received 20 Gy in 5 fractions over one week, with high-dose vertices within the tumour receiving 35 Gy in 5 fractions. The treatment plan was generated with the volumetric modulated arc technique (VMAT), and the surrounding normal tissue dose constraints were achieved. At one month after radiotherapy, her symptoms of pain and mass effect were well controlled. The patient experienced grade 1 lower gastrointestinal toxicity that subsided with medication and sustained no grade 3 or 4 toxicity. Response assessment at three months post radiotherapy showed an interval decrease in size and uptake of the right suprarenal lesion, with a drop in standardised uptake value maximum from 11.61 to 3.41. Lattice radiotherapy is a valuable technique for palliation in voluminous tumours. It should be further explored for feasibility and safety to provide better local control and quality of life to patients with large tumours.

Supplementary information: The online version contains supplementary material available at 10.1007/s13691-026-00845-7.

查看原文本刊更多论文

格点放射治疗转移性肾上腺皮质癌1例。

肾上腺皮质癌（ACC）是罕见的，转移性ACC与预后不良相关。姑息放疗对转移性疾病患者的症状控制是有价值的。在大肿瘤中，姑息性放疗需要均匀剂量的大容量照射，在这种情况下能否获得良好的反应是不确定的。点阵放射治疗（LRT）是一种独特的技术，可以在肿瘤内实现高剂量区域，为影响放射抵抗的因素提供优势。一位30岁的女士在腹部出现肿块，并被诊断为ACC伴肝和肺转移。为了缓解病情，她接受了化疗。6个周期后FDG-PET-CECT显示疾病进展。患者腹部肿大，有20 × 16 × 15 cm肿物浸润肝脏下表面，出现严重不适。患者计划采用LRT技术进行姑息性放疗。整个肿瘤在一周内接受了5次20 Gy的治疗，肿瘤内的高剂量顶点接受了5次35 Gy的治疗。使用体积调制电弧技术（VMAT）生成治疗方案，并获得周围正常组织的剂量约束。放疗后1个月，患者疼痛症状及肿块效应得到良好控制。患者出现1级低胃肠道毒性，用药后消退，无3级或4级毒性。放疗后3个月的疗效评估显示右侧肾上病变的大小和摄取间隔下降，标准化摄取值最大下降，从11.61降至3.41。点阵放射治疗是一种有价值的缓解大体积肿瘤的技术。为大肿瘤患者提供更好的局部控制和生活质量，应进一步探索其可行性和安全性。补充信息：在线版本包含补充资料，下载地址：10.1007/s13691-026-00845-7。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Cancer Conference Journal ONCOLOGY-

自引率

14.30%

发文量

期刊介绍： This online-only journal publishes original case reports on all types of cancer. In particular, we welcome not only case reports of educational value in the diagnosis and treatment of cancers, but also reports on molecularly analyzed cancer cases, including gene mutations, gene fusions, gene expression, and changes in copy number, regardless of their known clinical significance. Assessing the molecular analysis of a tumor usually requires a “cancer conference” in which experts from various fields discuss it. Even if the authors and their respective “cancer conference” were unable to determine the clinical significance of molecular changes at the time of submission and publication, their data may provide evidence that will help the scientific community develop precision medicine solutions in the future. We welcome case reports with reviews of the literature on similar cases, as they are more useful and valuable to readers than are reports of rare cases. International Cancer Conference Journal is the official publication of the Japan Society of Clinical Oncology (JSCO). - Presents an online-only collection of original case reports on all types of cancer - In particular, welcomes molecularly analyzed cancer cases - The Official Publication of the Japan Society of Clinical Oncology (JSCO)