RADIOTHERAPY OF ECTOPIC ACTH SYNDROME DUE TO THORACIC CARCINOIDS

From 1984 to 1990, six patients with histologically and endocrinologic ally proven ectopic ACTH syndrome were treated in our department. The lesion in five patients was clinically evident, but in the other was o ccult. Ah lesions were located within the chest. Four were thymic carc inoid and the other two were bronchial carcinoids. Most of the patient s had typical clinical manifestations of Gushing's syndrome. Laborator y tests including histopathological examination confirmed the diagnosi s of ectopic ACTH syndrome. The treatment consisted of surgical remova l of the mass supplemented by radiotherapy. The results showed that af ter treatment all patients had satisfactory remission. Two bronchial c arcinoid patients have been living for 40 and 88 months respectively w ithout recurrence. Among 4 thymic carcinoid patients, only one has bee n living with no tumor for 34 months. One patient had recurrence and t he other 2 died 32 and 50 months after the treatment respectively. How ever, the symptoms of two thymic carcinoid patients had not been relie ved at all unitl radiotherapy was given. This paper discusses the meth od, dose and indications of radiotherapy. It should be pointed out tha t the prognosis of bronchial carcinoids is good while that of thymic c arcinoids is relatively poor.