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Purpose We reviewed the experience of a tertiary cancer centre in the management of adrenocortical carcinoma (acc) treated over 40 years. We also searched the literature for guidelines related to the treatment of acc and for evidence for adjuvant radiation therapy (rt).Methods In a retrospective chart review, acc patients treated between January 1974 and December 2013 were identified, and patient demographics and tumour characteristics were extracted. Outcomes data, including dates and sites of failure, vital status, and cause of death, were collected. Overall survival was estimated using the Kaplan– Meier method. A medline search using PubMed, Ovid, and embase was used to review the literature about the role of rt and any available management guidelines for acc.Results Of 81 patients identified during the chart review, 39 had confirmed acc. In 32 patients, surgical resection was performed, including in 2 patients with M1 disease. Of those 32 patients, 16 received adjuvant systemic treatment (mitotane or concurrent chemoradiation). Only 6 patients received adjuvant rt, of whom 3 are still alive (2 living with distant failure). At a median follow-up of 3.8 years, 28 patients had died (72%), 10 were living (26%), and 1 had been lost to follow-up. Of the 22 patients for whom failure data were available, 2 experienced local failure, and the rest, distant failure.Conclusions The current data are insufficient to make treatment recommendations. Use of collaborative databases and consensus about diagnostic and therapeutic guidelines are warranted for better identification of optimum management. Adjuvant rt could be a reasonable option for R1 disease, but further research is needed.

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difference in acute and late gastrointestinal and genitourinary toxicities (modified Radiation Therapy Oncology Group [RTOG] definitions) were also assessed. Results: Between 2001 and 2012, 2301 men were treated with IMRT alone (median dose: 78 Gy); of these, 40% were low-, 36% intermediate-, and 24% high-risk, based on National Comprehensive Cancer Network criteria. MHS was reported in 232 men (10%); these men were less likely to have heart disease or diabetes (P<.05). MHSs contained a median of 3 identifiable ingredients (range, 0-30); the most common was saw palmetto (91%), followed by ingredients no different than standard multivitamins (5%), or no identifiable ingredients (4%). At a median follow-up time of 46 months (range 1e190 months), men taking an MHS had no difference compared to those not on MHSs in FFBF (among any risk group), CSS, or FFDM (Table). Differences in OS in men taking MHSs versus those not on MHSs were not significant after adjusting for risk covariates. RTOG acute and late toxicities were not different between the groups. Conclusion: MHS use is not associated with a change in cancer-related outcomes or toxicities in men receiving IMRT for prostate cancer.