Progress In Drug Treatment Of Adrenocortical Carcinoma

Adrenocortical carcinoma（ACC）is derived from the adrenal cortex,extremely rare, incidence rate is low.operation resection is the preferredtreatment of adrenalcortical carcinoma, it is the only possible way to cureACC.For unresectable disease or recurrence,it is is adjuvantsetting.Whether or not to give adjuvant mitotane after opration,there is stilla controversial issue.But we suggest that all patients who havehistologically high-grade disease (Ki67staining of>10percent of tumorcells,>20mitotic figures per50high-power fields (HPF) regardless oftumor size), intraoperative tumor spillage or fracture, and some largetumors that are low grade but have vascular or capsular invasion should useadjuvant mitotane. In the process of accepting the Mitota treatment, weshould make attention on serum mitotane levels etc,maybe some toxicitieswill appear,such as adrenal insufficiency, sexual dysfunction, thyroiddysfunction and gastrointestinal reaction and nervous system toxicity. Forpatients with bad clinical stage, mitotane may combined with cytotoxic chemotherapy drug for children with ACC, curative effect is relativelyclear.