Optimal treatment of adrenocortical carcinoma with mitotane: results in a consecutive series of 96 patients.
Optimal treatment of adrenocortical carcinoma with mitotane: results in a consecutive series of 96 patients.
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DOI：
10.1038/bjc.1994.183
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发表时间：
1994-05
影响因子：
8.8
通讯作者：
Krans, H. M. J.
中科院分区：
文献类型：
--
作者：
Haak, H. R.;Hermans, J.;Van De Velde, C. J. H.;Lentjes, E. G. W. M.;Goslings, B. M.;Fleuren, G.-J.;Krans, H. M. J.
米托坦被认为是不能手术、复发和转移性肾上腺皮质癌患者的首选药物，尽管这种药物对生存的有利影响从未被记录在案。我们评估了1959年至1992年间在我科随访的96例肾上腺皮质癌患者使用米托坦治疗的疗效。完全切除肿瘤是初始治疗的目标。米托坦治疗根据维持治疗的血清谷浓度进行分类：低（< 14mg -1）或高（>或= 14mg -1）。47例（49%）患者行肿瘤全切除术，37例（39%）患者行肿瘤次全切除术。接受肿瘤全切除术的患者存活时间明显长于未接受肿瘤全切除术的患者（P < 0.001）。辅助米托坦治疗（n = 11）不影响全切除后的生存。62名患者在其疾病期间的某个时间给予米托坦治疗，其中只有30人达到高维持血清水平。单因素分析（P < 0.01）和多因素分析（P = 0.01）显示，高血清水平米托坦治疗对患者生存有独立的有利影响。米托坦治疗导致低血清水平等于根本不给米托坦。我们的结论是，米托坦治疗肾上腺皮质癌是有效的，只有当高血清水平可以达到。
Mitotane is considered to be the drug of choice for patients with inoperable, recurrent and metastatic adrenocortical carcinoma, although a favourable effect of this drug on survival has never been documented. We evaluated the efficacy of mitotane treatment of 96 patients with adrenocortical carcinoma followed up in our department between 1959 and 1992. Complete tumour resection was the goal of the initial treatment. Mitotane treatment was classified according to serum trough concentrations on maintenance therapy: low (< 14 mg l-1) or high (> or = 14 mg l-1). Total tumour resection was feasible in 47 patients (49%), and subtotal resection was performed in 37 patients (39%). Patients who underwent total tumour resection survived significantly longer than those who did not (P < 0.001). Adjuvant mitotane therapy (n = 11) did not influence survival after total resection. Sixty-two patients were given mitotane treatment at some time during their illness, only 30 of whom reached high maintenance serum levels. Mitotane treatment with high serum levels had an independently favourable influence on patient survival, using univariate (P < 0.01) and multivariate analysis (P = 0.01). Mitotane treatment resulting in low serum levels was tantamount to not giving mitotane at all. We conclude that mitotane treatment in adrenocortical carcinoma is effective only when high serum levels can be achieved.
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DOI：
10.1530/acta.0.1240526
发表时间：
1991-05-01
期刊：
ACTA ENDOCRINOLOGICA
影响因子：
--
作者：
VANSETERS, AP;MOOLENAAR, AJ
通讯作者：
MOOLENAAR, AJ
影响因子：
5
作者：
MOOLENAAR, AJ;NIEWINT, JWM;OEI, IT
通讯作者：
OEI, IT
影响因子：
158.5
作者：
LUTON, JP;CERDAS, S;BRICAIRE, H
通讯作者：
BRICAIRE, H
影响因子：
3
作者：
MOOLENAAR, AJ;VANSLOOTEN, H;SMEENK, D
通讯作者：
SMEENK, D
影响因子：
120.7
作者：
LUBITZ, JA;FREEMAN, L;OKUN, R
通讯作者：
OKUN, R