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<p>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&#xa0;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&#xa0;Gy in 5 fractions over one week, with high-dose vertices within the tumour receiving 35&#xa0;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.</p>

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Lattice radiotherapy for palliation in a case of metastatic adrenocortical carcinoma

  • 期刊论文

  • 发表日期：

    2026年2月5日

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  • NP Jayashree,
  • C Shambhavi,
  • Sumeet Suresh Malapure,
  • Ananth Pai,
  • Naveen Salins,
  • Shirley Lewis

摘要

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.