This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dickstein, G. Articles by Nativ, O. Search for Related Content PubMed PubMed Citation Articles by Dickstein, G. Articles by Nativ, O.

Is There a Role for Low Doses of Mitotane (o,p'-DDD) as Adjuvant Therapy in Adrenocortical Carcinoma?

Division of Endocrinology (G.D., C.S., E.A.) and Department of Urology (O.N.), Bnai Zion Medical Center, Haifa, Israel, and Department of Chest Surgery, Rambam Medical Center (L.-A. B.), Haifa, Israel

Address all correspondence and requests for reprints to: Gabriel Dickstein, Division of Endocrinology, Bnai Zion Medical Center, P.O. Box 4940, Haifa, 31048, Israel.

Four patients suffering from adrenocortical carcinoma were treated with low doses (1.5–2.0 g) of mitotane (o,p'-DDD) for the complete follow-up time following surgery (21–68 months). Treatment with mitotane was started shortly after surgical removal of the tumor (three patients) or the tumor and multiple lung metastasis (one patient). No significant side effects or complications from the medication were noted. Two patients remain disease free after 57 and 21 months on treatment. A third patient died of an unrelated reason (varicose vein bleeding) after 68 months on mitotane without evidence of tumor recurrence or metastasis. In the fourth patient, two lung metastasis were successfully removed after 48 months of follow-up. The patient is doing well and is disease free 6 months later. Though our series is too small to draw final conclusions, we suggest that low doses of mitotane, which are well tolerated, might offer prolonged disease-free survival in adrenocortical carcinoma. To be beneficial treatment has to be started early after surgical removal of the tumor and metastasis, and be continued for long periods of time.

This article has been cited by other articles:

				F. Daffara, S. De Francia, G. Reimondo, B. Zaggia, E. Aroasio, F. Porpiglia, M. Volante, A. Termine, F. Di Carlo, L. Dogliotti, et al. Prospective evaluation of mitotane toxicity in adrenocortical cancer patients treated adjuvantly Endocr. Relat. Cancer, December 1, 2008; 15(4): 1043 - 1053. [Abstract] [Full Text] [PDF]

				I G C Hermsen, H Gelderblom, J Kievit, J A Romijn, and H R Haak Extremely long survival in six patients despite recurrent and metastatic adrenal carcinoma. Eur. J. Endocrinol., June 1, 2008; 158(6): 911 - 919. [Abstract] [Full Text] [PDF]

				J. Bertherat, J. Coste, X. Bertagna, G. Dickstein, C. Shechner, O. Nativ, J. E. Lee, A. Machens, H. Dralle, M. Terzolo, et al. Adjuvant Mitotane in Adrenocortical Carcinoma N. Engl. J. Med., September 20, 2007; 357(12): 1256 - 1259. [Full Text] [PDF]

				M. Terzolo, A. Angeli, M. Fassnacht, F. Daffara, L. Tauchmanova, P. A. Conton, R. Rossetto, L. Buci, P. Sperone, E. Grossrubatscher, et al. Adjuvant Mitotane Treatment for Adrenocortical Carcinoma N. Engl. J. Med., June 7, 2007; 356(23): 2372 - 2380. [Abstract] [Full Text] [PDF]

				D. E. Schteingart Adjuvant Mitotane Therapy of Adrenal Cancer -- Use and Controversy N. Engl. J. Med., June 7, 2007; 356(23): 2415 - 2418. [Full Text] [PDF]

				N. Nader, G. Raverot, A. Emptoz-Bonneton, H. Dechaud, M. Bonnay, E. Baudin, and M. Pugeat Mitotane Has an Estrogenic Effect on Sex Hormone-Binding Globulin and Corticosteroid-Binding Globulin in Humans J. Clin. Endocrinol. Metab., June 1, 2006; 91(6): 2165 - 2170. [Abstract] [Full Text] [PDF]

				B. Allolio and M. Fassnacht Adrenocortical Carcinoma: Clinical Update J. Clin. Endocrinol. Metab., June 1, 2006; 91(6): 2027 - 2037. [Abstract] [Full Text] [PDF]

				M. L. Kendrick, R. Lloyd, L. Erickson, D. R. Farley, C. S. Grant, G. B. Thompson, C. Rowland, W. F. Young Jr, and J. A. van Heerden Adrenocortical Carcinoma: Surgical Progress or Status Quo? Arch Surg, May 1, 2001; 136(5): 543 - 549. [Abstract] [Full Text] [PDF]

				T. Rainis, S. Ben-Haim, and G. Dickstein False Positive Metaiodobenzylguanidine Scan in a Patient with a Huge Adrenocortical Carcinoma J. Clin. Endocrinol. Metab., January 1, 2000; 85(1): 5 - 7. [Abstract] [Full Text]

				L. Barzon, F. Fallo, and N. Sonino Comment--Is There a Role for Low Doses of Mitotane (o,p'-DDD) as Adjuvant Therapy in Adrenocortical Carcinoma? J. Clin. Endocrinol. Metab., April 1, 1999; 84(4): 1488 - 1488. [Full Text]

				G. Dickstein Is There a Role for Low Doses of Mitotane (o,p',DDD) as Adjuvant Therapy in Adrenocortical Carcinoma?--Authors' Response J. Clin. Endocrinol. Metab., April 1, 1999; 84(4): 1488a - 1489. [Full Text]