BACKGROUND: The purpose of this study was to compare outcomes in patients with anal canal squamous cell carcinoma (SCCA) who were treated with definitive chemoradiotherapy by either intensity-modulated radiation therapy (IMRT) or conventional radiotherapy (CRT). METHODS: Forty-six patients who received definitive chemoradiotherapy from January 1993 to August 2009 were included. Forty-five patients received 5-fluorouracil with mitomycin C (n = 39) or cisplatin (n = 6). Seventeen (37%) were treated with CRT and 29 (63%) with IMRT. The median dose was 54 Gy in both groups. Median follow-up was 26 months (CRT) and 32 months (IMRT). T3-T4 stage (P = .18) and lymph node-positive disease (P = .6) were similar between groups. RESULTS: The CRT group required longer treatment duration (57 days vs 40 days, P < .0001), more treatment breaks (88% vs 34.5%, P = .001), and longer breaks (12 days vs 1.5 days, P < .0001) than patients treated with IMRT. Eleven (65%) patients in the CRT group experienced grade >2 nonhematologic toxicity compared with 6 (21%) patients in the IMRT group (P = .003). The 3-year overall survival (OS), locoregional control (LRC), and progression-free survival were 87.8%, 91.9%, and 84.2%, respectively, for the IMRT groups and 51.8%, 56.7%, and 56.7%, respectively, for the CRT group (all P < .01). On multivariate analysis, T stage, use of IMRT, and treatment duration were associated with OS, and T stage and use of IMRT were associated with LRC. CONCLUSIONS: The use of IMRT was associated with less toxicity, reduced need for treatment breaks, and excellent LRC and OS compared with CRT in patients with SCCA of the anal canal.
BACKGROUND: The purpose of this study was to compare outcomes in patients with anal canal squamous cell carcinoma (SCCA) who were treated with definitive chemoradiotherapy by either intensity-modulated radiation therapy (IMRT) or conventional radiotherapy (CRT). METHODS: Forty-six patients who received definitive chemoradiotherapy from January 1993 to August 2009 were included. Forty-five patients received 5-fluorouracil with mitomycin C (n = 39) or cisplatin (n = 6). Seventeen (37%) were treated with CRT and 29 (63%) with IMRT. The median dose was 54 Gy in both groups. Median follow-up was 26 months (CRT) and 32 months (IMRT). T3-T4 stage (P = .18) and lymph node-positive disease (P = .6) were similar between groups. RESULTS: The CRT group required longer treatment duration (57 days vs 40 days, P < .0001), more treatment breaks (88% vs 34.5%, P = .001), and longer breaks (12 days vs 1.5 days, P < .0001) than patients treated with IMRT. Eleven (65%) patients in the CRT group experienced grade >2 nonhematologic toxicity compared with 6 (21%) patients in the IMRT group (P = .003). The 3-year overall survival (OS), locoregional control (LRC), and progression-free survival were 87.8%, 91.9%, and 84.2%, respectively, for the IMRT groups and 51.8%, 56.7%, and 56.7%, respectively, for the CRT group (all P < .01). On multivariate analysis, T stage, use of IMRT, and treatment duration were associated with OS, and T stage and use of IMRT were associated with LRC. CONCLUSIONS: The use of IMRT was associated with less toxicity, reduced need for treatment breaks, and excellent LRC and OS compared with CRT in patients with SCCA of the anal canal.
Authors: Michael D Chuong; Jessica M Freilich; Sarah E Hoffe; William Fulp; Jill M Weber; Khaldoun Almhanna; William Dinwoodie; Nikhil Rao; Kenneth L Meredith; Ravi Shridhar Journal: Gastrointest Cancer Res Date: 2013-03
Authors: Theodore S Hong; Jennifer L Pretz; Joseph M Herman; May Abdel-Wahab; Nilofer Azad; A William Blackstock; Prajnan Das; Karyn A Goodman; Salma K Jabbour; William E Jones; Andre A Konski; Albert C Koong; Miguel Rodriguez-Bigas; William Small; Charles R Thomas; Jennifer Zook; W Warren Suh Journal: Gastrointest Cancer Res Date: 2014-01
Authors: Eleonor Rivin Del Campo; Oscar Matzinger; Karin Haustermans; Didier Peiffert; Robert Glynne-Jones; Kathryn A Winter; Andre A Konski; Jaffer A Ajani; Jean-François Bosset; Jean-Michel Hannoun-Levi; Marc Puyraveau; A Bapsi Chakravarthy; Helen Meadows; John Northover; Laurence Collette; Melissa Christiaens; Philippe Maingon Journal: Eur J Cancer Date: 2019-09-28 Impact factor: 9.162
Authors: Joseph Paul Weiner; Andrew Thomas Wong; David Schwartz; Manuel Martinez; Ayse Aytaman; David Schreiber Journal: World J Gastroenterol Date: 2016-08-21 Impact factor: 5.742