Maïlys de Meric de Bellefon1, Claire Lemanski2, Florence Castan3, Emmanuelle Samalin4, Thibault Mazard4, Alexis Lenglet2, Sylvain Demontoy2, Olivier Riou2, Carmen Llacer-Moscardo2, Pascal Fenoglietto2, Norbert Aillères2, Simon Thezenas3, Charles Debrigode5, Sabine Vieillot6, Sophie Gourgou3, David Azria2. 1. Department of Radiation Oncology, University Federation of Radiation Oncology Montpellier-Nîmes, ICM, Montpellier Cancer Institute - University of Montpellier, France. Electronic address: Mailys.De-Meric-de-Bellefon@icm.unicancer.fr. 2. Department of Radiation Oncology, University Federation of Radiation Oncology Montpellier-Nîmes, ICM, Montpellier Cancer Institute - University of Montpellier, France. 3. Biometrics Unit ICM, Montpellier Cancer Institute - University of Montpellier, France. 4. Department of Medical Oncology, ICM, Montpellier Cancer Institute - University of Montpellier, INSERM U1194, IRCM, France. 5. Department of Radiation Oncology, University Federation of Radiation Oncology Montpellier-Nîmes, CHU Nîmes, France. 6. Department of Radiation Oncology, Catalan Oncology Center, Perpignan, France.
Abstract
BACKGROUND AND PURPOSE: To assess the long-term outcomes of patients with squamous cell carcinoma of the anal canal (SCCAC) treated with Intensity-Modulated Radiation Therapy (IMRT). MATERIAL AND METHODS: From 2007 to 2015, 193 patients were treated by IMRT for SCCAC. Radiotherapy delivered 45 Gy in 1.8 Gy daily-fractions to the primary tumor and elective nodal areas, immediately followed by a boost of 14.4-20 Gy to the primary tumor and involved nodes. Concurrent chemotherapy with 5-FU-mitomycin (MMC) or cisplatin was added for locally advanced tumors. Survivals were estimated by Kaplan-Meier method. Locoregional (LR) relapses were precisely assessed. Prognostic factors were evaluated by uni- and multivariate analyses. Late toxicity was scored according to the Common Toxicity Criteria for Adverse Events v4.0. RESULTS: Median follow-up was 70 months (range, 1-131). Forty-nine men (25%) and 144 women (75%) were analyzed. Median age was 62 years. Tumor stages were I, II, III and IV in 7%, 24%, 63% and 6% of cases, respectively. Chemotherapy was delivered in 167 patients (87%), mainly MMC (80%). Five-year OS, DFS, CFS and LR control rates were 74%, 68%, 66% and 85%, respectively. Forty-one patients (21%) had a relapse: 22 were LR, mostly in-field (68%). Predictors for LR failure were exclusive radiotherapy, chemotherapy lacking MMC and treatment breaks >3 days. Overall late toxicity ≥grade 2 occurred in 43% of patients, with 24% grade 3 and one case of grade 4 (hematuria). CONCLUSION: CRT with IMRT assures excellent local control in locally advanced SCCAC with manageable long-term toxicity. Multicentric prospective trials are required to reinforce those results.
BACKGROUND AND PURPOSE: To assess the long-term outcomes of patients with squamous cell carcinoma of the anal canal (SCCAC) treated with Intensity-Modulated Radiation Therapy (IMRT). MATERIAL AND METHODS: From 2007 to 2015, 193 patients were treated by IMRT for SCCAC. Radiotherapy delivered 45 Gy in 1.8 Gy daily-fractions to the primary tumor and elective nodal areas, immediately followed by a boost of 14.4-20 Gy to the primary tumor and involved nodes. Concurrent chemotherapy with 5-FU-mitomycin (MMC) or cisplatin was added for locally advanced tumors. Survivals were estimated by Kaplan-Meier method. Locoregional (LR) relapses were precisely assessed. Prognostic factors were evaluated by uni- and multivariate analyses. Late toxicity was scored according to the Common Toxicity Criteria for Adverse Events v4.0. RESULTS: Median follow-up was 70 months (range, 1-131). Forty-nine men (25%) and 144 women (75%) were analyzed. Median age was 62 years. Tumor stages were I, II, III and IV in 7%, 24%, 63% and 6% of cases, respectively. Chemotherapy was delivered in 167 patients (87%), mainly MMC (80%). Five-year OS, DFS, CFS and LR control rates were 74%, 68%, 66% and 85%, respectively. Forty-one patients (21%) had a relapse: 22 were LR, mostly in-field (68%). Predictors for LR failure were exclusive radiotherapy, chemotherapy lacking MMC and treatment breaks >3 days. Overall late toxicity ≥grade 2 occurred in 43% of patients, with 24% grade 3 and one case of grade 4 (hematuria). CONCLUSION: CRT with IMRT assures excellent local control in locally advanced SCCAC with manageable long-term toxicity. Multicentric prospective trials are required to reinforce those results.
Authors: Sara E Beltrán Ponce; Beth A Erickson; William A Hall; Meena Bedi; Michael J Martens; Malika Siker; James Thomas; Ben George; Kirk Ludwig; Carrie Peterson; Timothy Ridolfi; John M Longo Journal: J Gastrointest Oncol Date: 2022-02
Authors: Alexandra Gilbert; Ane L Appelt; Stelios Theophanous; Robert Samuel; John Lilley; Ann Henry; David Sebag-Montefiore Journal: BMC Cancer Date: 2022-06-03 Impact factor: 4.638
Authors: Emma B Holliday; Van K Morris; Benny Johnson; Cathy Eng; Ethan B Ludmir; Prajnan Das; Bruce D Minsky; Cullen Taniguchi; Grace L Smith; Eugene J Koay; Albert C Koong; Marc E Delclos; John M Skibber; Miguel A Rodriguez-Bigas; Y Nancy You; Brian K Bednarski; Mathew M Tillman; George J Chang; Kristofer Jennings; Craig A Messick Journal: Oncologist Date: 2022-02-03