Efficacy and Safety of Radiotherapy and Systemic Treatments in Adrenocortical Carcinoma: Systematic Review and Meta-Analysis
Authors' conclusion
Mitotane significantly improves survival outcomes in patients with ACC, while radiotherapy exhibits potential benefits, particularly in localized disease. Further research is needed to verify the efficacy of cytotoxic chemotherapy, and randomized controlled trials are required to provide robust evidence of different treatment approaches.
Study context
- Population
- Patients with adrenocortical carcinoma (ACC)86 studies
- Comparison
- Nonsurgical treatments vs no such treatment
- Outcome
- Overall survival (OS) and recurrence-free survival (RFS)
Methodological details3 databases (PubMed, Embase, CENTRAL), independent data extraction by two reviewers
- 3 databases (PubMed, Embase, CENTRAL)
- Independent data extraction by two reviewers
Pooled result
As reported in the abstract
Estimate (CI)
Mitotanevs Without treatment
aHR (OS) 0.54(0.41–0.70)
Mitotanevs Without treatment
aHR (RFS) 0.60(0.43–0.84)
Radiotherapyvs Without treatmenttrend
aHR (OS) 0.66(0.38–1.15)
Radiotherapyvs Without treatmenttrend
aHR (RFS) 0.65(0.35–1.23)
Cytotoxic chemotherapyvs Without treatmentuncertain
aHR (OS) 0.61(0.08–4.78)
Further pooled results
| Outcome | Estimate | |
|---|---|---|
| OS and RFS, stage I-III diseaseMitotanevs Without treatment | aHR (OS) 0.71 (CI 0.52–0.98) | |
| OS and RFS, stage I-III diseaseMitotanevs Without treatment | aHR (RFS) 0.65 (CI 0.50–0.85) | |
| OS and RFS, stage I-III diseaseRadiotherapyvs Without treatment | aHR (OS) 0.68 (CI 0.50–0.93) | |
| OS and RFS, stage I-III diseaseRadiotherapyvs Without treatment | aHR (RFS) 0.71 (CI 0.63–0.81) | |
| 0.512Ratio (log scale) |
Original publication
Efficacy and Safety of Radiotherapy and Systemic Treatments in Adrenocortical Carcinoma: Systematic Review and Meta-Analysis. J Clin Endocrinol Metab. Published 11 August 2025. doi:10.
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