Pierfrancesco Franco1, Francesca Arcadipane2, Riccardo Ragona2, Massimiliano Mistrangelo3, Paola Cassoni4, Nadia Rondi5, Mario Morino3, Patrizia Racca6, Umberto Ricardi2. 1. Department of Oncology-Radiation Oncology, University of Turin, Turin, Italy pierfrancesco.franco@unito.it. 2. Department of Oncology-Radiation Oncology, University of Turin, Turin, Italy. 3. Department of Surgical Sciences, University of Turin, Turin, Italy. 4. Department of Medical Sciences, University of Turin, Turin, Italy. 5. Department of Medical Imaging and Radiotherapy-Radiation Oncology, City of Health and Science Hospital, Turin, Italy. 6. Oncological Centre for Gastrointestinal Neoplasm, Medical Oncology 1, City of Health and Science Hospital, Turin, Italy.
Abstract
AIM: To report clinical outcomes of a consecutive series of patients with early-stage (T1-T1N0) anal cancer treated with intensity-modulated radiotherapy (IMRT) and a simultaneous integrated boost (SIB) approach similarly to the RTOG 05-29 trial. PATIENTS AND METHODS: A cohort of 43 patients underwent SIB-IMRT employing a schedule consisting of 50.4 Gy/28 fractions to the gross tumor volume and 42 Gy/28 fractions to the elective nodal volumes for cT1N0 cases, and 54 Gy/30 fractions and 45 Gy/30 fractions to the same volumes for cT2N0 cases. Chemotherapy was administered concurrently following Nigro's regimen. The primary endpoint was colostomy-free survival (CFS). Secondary endpoints were locoregional control (LRC), disease-free (DFS), cancer-specific (CSS) and overall (OS) survival. RESULTS: Median follow-up was 39.7 months. The actuarial 3-year CFS was 79.4% [95% confidence interval (CI)=61.4-89.7%]. Actuarial 3-year OS and CSS were 90.8% (95% CI=74.1-96.9%) and 93.8% (95% CI=77.3-98.4%), while DFS was 75.5% (95% CI=56.4-87.1%). Actuarial 3-year LRC was 86.1% (95% CI=69.6-94%). On multivariate analysis, tumor size >3 cm showed a trend towards significance in predicting CFS [hazard ratio (HR)=8.6, 95% CI=84.7-88.1%; p=0.069]. Maximum detected adverse events included: skin (G3): 18%; gastrointestinal tract (G2): 67%; genitourinary tract (G3): 3%; genitalia (G2): 30%; anemia (G2): 7%; leukopenia (G3): 26%, leukopenia (G4):7%; neutropenia (G3): 15%; neutropenia (G4): 12%; thrombocytopenia (G3): 9%. CONCLUSION: Our clinical results support the use of SIB-IMRT in the combined modality treatment of patients with anal cancer. Copyright
AIM: To report clinical outcomes of a consecutive series of patients with early-stage (T1-T1N0) anal cancer treated with intensity-modulated radiotherapy (IMRT) and a simultaneous integrated boost (SIB) approach similarly to the RTOG 05-29 trial. PATIENTS AND METHODS: A cohort of 43 patients underwent SIB-IMRT employing a schedule consisting of 50.4 Gy/28 fractions to the gross tumor volume and 42 Gy/28 fractions to the elective nodal volumes for cT1N0 cases, and 54 Gy/30 fractions and 45 Gy/30 fractions to the same volumes for cT2N0 cases. Chemotherapy was administered concurrently following Nigro's regimen. The primary endpoint was colostomy-free survival (CFS). Secondary endpoints were locoregional control (LRC), disease-free (DFS), cancer-specific (CSS) and overall (OS) survival. RESULTS: Median follow-up was 39.7 months. The actuarial 3-year CFS was 79.4% [95% confidence interval (CI)=61.4-89.7%]. Actuarial 3-year OS and CSS were 90.8% (95% CI=74.1-96.9%) and 93.8% (95% CI=77.3-98.4%), while DFS was 75.5% (95% CI=56.4-87.1%). Actuarial 3-year LRC was 86.1% (95% CI=69.6-94%). On multivariate analysis, tumor size >3 cm showed a trend towards significance in predicting CFS [hazard ratio (HR)=8.6, 95% CI=84.7-88.1%; p=0.069]. Maximum detected adverse events included: skin (G3): 18%; gastrointestinal tract (G2): 67%; genitourinary tract (G3): 3%; genitalia (G2): 30%; anemia (G2): 7%; leukopenia (G3): 26%, leukopenia (G4):7%; neutropenia (G3): 15%; neutropenia (G4): 12%; thrombocytopenia (G3): 9%. CONCLUSION: Our clinical results support the use of SIB-IMRT in the combined modality treatment of patients with anal cancer. Copyright
Authors: V Dell'Acqua; J Kobiela; F Kraja; M C Leonardi; A Surgo; M A Zerella; S Arculeo; C Fodor; R Ricotti; M G Zampino; S Ravenda; G Spinoglio; R Biffi; A Bazani; R Luraschi; S Vigorito; P Spychalski; R Orecchia; R Glynne-Jones; B A Jereczek-Fossa Journal: Med Oncol Date: 2018-03-28 Impact factor: 3.064