Kurian Joseph1, Yugmel Nijjar2, Heather Warkentin3, Dan Schiller4, Keith Tankel2, Nawaid Usmani2, Diane Severin2, Sunita Ghosh5, Alasdair Syme3, Tirath Nijjar2, Karen Mulder5, Corinne Doll6, Clarence Wong7, Colin Field3. 1. Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada. Electronic address: kurian.joseph@albertahealthservices.ca. 2. Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada. 3. Division of Medical Physics, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada. 4. Department of Surgical Oncology, University of Alberta & Alberta Health Services, Edmonton, Canada. 5. Division of Medical Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Canada. 6. Division of Radiation Oncology, Department of Oncology, University of Calgary & Tom Baker Cancer Centre, Canada. 7. Department of Internal Gastroenterology, Royal Alexandra Hospital, Edmonton, Canada.
Abstract
BACKGROUND AND PURPOSE: To evaluate toxicity, local control, and survival of anal cancer patients treated with helical tomotherapy (HT) and concurrent 5-fluorouracil and mitomycin-C (5FU/MMC). MATERIALS AND METHODS: Fifty-seven patients were treated with HT and concurrent 5FU/MMC. The planning objectives were to deliver 54 Gy to the tumor (PTV54) and 45 Gy to the nodes at risk (PTV45) in 30 fractions. Patients were reviewed for toxicity weekly during HT, every 6 weeks for 3 months, and then every 3-4 months for 5 years. RESULTS: The median follow-up was 40 months. The median age was 58 years (range: 37-83). Stage distribution: stage II-48%, IIIA-18%, IIIB-34%. The majority of patients developed ⩽ grade 2 acute toxicity scores. The most common ⩾ grade 3 acute toxicity was neutropenia (40%). Common late toxicities were grade 2 anal incontinence (16%) and telangiectasia (12%). The 3 year colostomy-free survival rate was 77% (95% CI: 61-87%), 3 year disease-free survival rate was 80% (CI: 66-89%), and 3 year overall survival was 91% (CI: 77-96%). CONCLUSIONS: Incorporation of HT with concurrent 5FU/MMC had low treatment-related acute and late morbidity with few treatment breaks. However, the expected dosimetric benefit for hematological toxicity was not experienced clinically.
BACKGROUND AND PURPOSE: To evaluate toxicity, local control, and survival of anal cancerpatients treated with helical tomotherapy (HT) and concurrent 5-fluorouracil and mitomycin-C (5FU/MMC). MATERIALS AND METHODS: Fifty-seven patients were treated with HT and concurrent 5FU/MMC. The planning objectives were to deliver 54 Gy to the tumor (PTV54) and 45 Gy to the nodes at risk (PTV45) in 30 fractions. Patients were reviewed for toxicity weekly during HT, every 6 weeks for 3 months, and then every 3-4 months for 5 years. RESULTS: The median follow-up was 40 months. The median age was 58 years (range: 37-83). Stage distribution: stage II-48%, IIIA-18%, IIIB-34%. The majority of patients developed ⩽ grade 2 acute toxicity scores. The most common ⩾ grade 3 acute toxicity was neutropenia (40%). Common late toxicities were grade 2 anal incontinence (16%) and telangiectasia (12%). The 3 year colostomy-free survival rate was 77% (95% CI: 61-87%), 3 year disease-free survival rate was 80% (CI: 66-89%), and 3 year overall survival was 91% (CI: 77-96%). CONCLUSIONS: Incorporation of HT with concurrent 5FU/MMC had low treatment-related acute and late morbidity with few treatment breaks. However, the expected dosimetric benefit for hematological toxicity was not experienced clinically.
Authors: Najla Slim; Paolo Passoni; Elena Incerti; Roberta Tummineri; Calogero Gumina; Giovanni Mauro Cattaneo; Paola De Nardi; Carla Canevari; Claudio Fiorino; Monica Ronzoni; Andrea Marco Tamburini; Valentina Burgio; Luigi Gianolli; Nadia Di Muzio Journal: Sci Rep Date: 2020-09-03 Impact factor: 4.379
Authors: Krishan R Jethwa; Courtney N Day; Harigopal Sandhyavenu; Karthik Gonuguntla; William S Harmsen; William G Breen; David M Routman; Allison E Garda; Joleen M Hubbard; Thorvardur R Halfdanarson; Michelle A Neben-Wittich; Kenneth W Merrell; Christopher L Hallemeier; Michael G Haddock Journal: Clin Transl Radiat Oncol Date: 2021-02-23
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