IS THERE A ROLE FOR LOW-DOSES OF MITOTANE (O,P'-DDD) AS ADJUVANT THERAPY IN ADRENOCORTICAL CARCINOMA

Four patients suffering from adrenocortical carcinoma were treated wit h 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 tone patient). No significan t side effects or complications from the medication were noted. Two pa tients remain disease free after 57 and 21 months on treatment. A thir d patient died of an unrelated reason (varicose vein bleeding) after 6 8 months on mitotane without evidence of tumor recurrence or metastasi s. In the fourth patient, two lung metastasis were successfully remove d after 48 months of follow-up. The patient is doing well and is disea se free 6 months later. Though our series is too small to draw final c onclusions, we suggest that low doses of mitotane, which are well tole rated, might offer prolonged disease-free survival in adrenocortical c arcinoma. To be beneficial treatment has to be started early after sur gical removal of the tumor and metastasis, and be continued for long p eriods of time.