肾上腺皮质癌的治疗新进展

Research progress of the treatment of adrenocortical carcinoma

肾上腺皮质癌(adrenocoritical carcinoma,ACC)是一种罕见、恶性度高的内分泌肿瘤,预后不良。随着研究的不断深入,针对ACC的治疗方法越来越丰富。手术是目前最有效的治疗方法,米托坦是ACC术后的主要辅助治疗用药。对于无法手术或手术不能完全切除者可考虑化疗、放疗等。另外,分子靶向治疗在ACC中可能有巨大的潜力,包括酪氨酸受体抑制剂、胰岛素样生长因子1受体抑制剂、哺乳动物雷帕霉素靶蛋白抑制剂等。近年还涌现出免疫治疗及针对基因突变相关位点的治疗方法。如何根据患者特点,选择最佳的个体化治疗方案是今后研究的重要方向之一。

Adrenocortical carcinoma(ACC)is a rare and highly aggressive endocrine tumor with a poor prognosis.With the research deepens,an increasing variety of treatments for ACC are available now.Surgery is currently the most effective treatment,and adjuvant mitotane therapy is the main postoperative regimen for ACC.Chemotherapy and radiotherapy are considered for those who cannot be operated or cannot be completely removed by surgery.In addition,molecular targeted therapy may have great potential in ACC,including tyrosine receptor inhibitors,insulin-like growth factor I receptor inhibitors,mTOR inhibitors,etc.Immunotherapies and treatments targeting gene mutation-associated loci have also emerged in recent years.To choose the best regimens is an important research direction for the present and the future.