A Gilbert1, K Drinkwater2, L McParland3, R Adams4, R Glynne-Jones5, M Harrison5, M A Hawkins6, D Sebag-Montefiore7, D C Gilbert8, R Muirhead9. 1. University of Leeds, Leeds Cancer Centre, St. James's University Hospital, Leeds, UK. Electronic address: a.gilbert@leeds.ac.uk. 2. The Royal College of Radiologists, London, UK. 3. Leeds Clinical Trials Research Unit, Worsley Building, University of Leeds, Leeds, UK. 4. Cardiff University - Centre for Trials Research and Velindre Cancer Centre, Cardiff, UK. 5. Mount Vernon Centre for Cancer Treatment, Mount Vernon Hospital, Rickmansworth Road, Northwood, UK. 6. CRUK MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, UK. 7. University of Leeds, Leeds Cancer Centre, St. James's University Hospital, Leeds, UK. 8. Sussex Cancer Centre, Royal Sussex County Hospital, Eastern Road, Brighton, UK. 9. Oxford University Hospitals NHS Trust, Department of Oncology, Churchill Hospital, Oxford, UK.
Abstract
BACKGROUND: Concurrent chemoradiotherapy is the standard treatment for anal cancer. Following national UK implementation of intensity-modulated radiotherapy (IMRT), this prospective, national cohort evaluates the one-year oncological outcomes and patient-reported toxicity outcomes (PRO) after treatment. MATERIALS AND METHODS: A national cohort of UK cancer centers implementing IMRT was carried out between February to July 2015. Cancer centers provided data on oncological outcomes, including survival, and disease and colostomy status at one-year. EORTC-QLQ core (C30) and colorectal (CR29) questionnaires were completed at baseline and one-year followup. The PRO scores at baseline and one year were compared. RESULTS: 40 UK Cancer Centers returned data with a total of 187 patients included in the analysis. 92% received mitomycin with 5-fluorouracil or capecitabine. One-year overall survival was 94%; 84% were disease-free and 86% colostomy-free at one-year followup. At one year, PRO results found significant improvements in buttock pain, blood and mucus in stools, pain, constipation, appetite loss, and health anxiety compared to baseline. No significant deteriorations were reported in diarrhea, bowel frequency, and flatulence. Urinary symptom scores were low at one year. Moderate impotence symptoms at baseline remained at one year, and a moderate deterioration in dyspareunia reported. CONCLUSIONS: With national anal cancer IMRT implementation, at this early pre-defined time point, one-year oncological outcomes were reassuring and resulted in good disease-related symptom control. one-year symptomatic complications following CRT for anal cancer using IMRT techniques appear to be relatively mild. These PRO results provide a basis to benchmark future studies.
BACKGROUND: Concurrent chemoradiotherapy is the standard treatment for anal cancer. Following national UK implementation of intensity-modulated radiotherapy (IMRT), this prospective, national cohort evaluates the one-year oncological outcomes and patient-reported toxicity outcomes (PRO) after treatment. MATERIALS AND METHODS: A national cohort of UK cancer centers implementing IMRT was carried out between February to July 2015. Cancer centers provided data on oncological outcomes, including survival, and disease and colostomy status at one-year. EORTC-QLQ core (C30) and colorectal (CR29) questionnaires were completed at baseline and one-year followup. The PRO scores at baseline and one year were compared. RESULTS: 40 UK Cancer Centers returned data with a total of 187 patients included in the analysis. 92% received mitomycin with 5-fluorouracil or capecitabine. One-year overall survival was 94%; 84% were disease-free and 86% colostomy-free at one-year followup. At one year, PRO results found significant improvements in buttock pain, blood and mucus in stools, pain, constipation, appetite loss, and health anxiety compared to baseline. No significant deteriorations were reported in diarrhea, bowel frequency, and flatulence. Urinary symptom scores were low at one year. Moderate impotence symptoms at baseline remained at one year, and a moderate deterioration in dyspareunia reported. CONCLUSIONS: With national anal cancer IMRT implementation, at this early pre-defined time point, one-year oncological outcomes were reassuring and resulted in good disease-related symptom control. one-year symptomatic complications following CRT for anal cancer using IMRT techniques appear to be relatively mild. These PRO results provide a basis to benchmark future studies.
Authors: Kelsey L Corrigan; Brian De; Michael K Rooney; Ethan B Ludmir; Prajnan Das; Grace L Smith; Cullen M Taniguchi; Bruce D Minsky; Eugene J Koay; Albert C Koong; Emma B Holliday Journal: Adv Radiat Oncol Date: 2022-04-30
Authors: C R Hanna; F Slevin; A Appelt; M Beavon; R Adams; C Arthur; M Beasley; A Duffton; A Gilbert; S Gollins; M Harrison; M A Hawkins; K Laws; S O'Cathail; P Porcu; M Robinson; D Sebag-Montefiore; M Teo; S Teoh; R Muirhead Journal: Clin Oncol (R Coll Radiol) Date: 2021-01-08 Impact factor: 4.126