Modern intensity-modulated radiotherapy with image guidance allows low toxicity rates and good local control in chemoradiotherapy for anal cancer patients.
- De Bari B Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois-CHUV, Lausanne, Switzerland. bdebari@chu-besancon.fr.
- Lestrade L Radiation Oncology Department, Centre Hospitalier Régional Universitaire "Jean Minjoz", INSERM U1098 EFS/BFC, 3, Boulevard Fleming, 25000, Besançon Cedex, France.
- Franzetti-Pellanda A Radiation Oncology Department, Clinica Luganese, Lugano, Switzerland.
- Jumeau R Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois-CHUV, Lausanne, Switzerland.
- Biggiogero M Radiation Oncology Department, Clinica Luganese, Lugano, Switzerland.
- Kountouri M Radiation Oncology Department, Geneva University Hospital, Geneva, Switzerland.
- Matzinger O Radiation Oncology Department, Riviera-Chablais Hospital, Vevey, Switzerland.
- Miralbell R Radiation Oncology Department, Geneva University Hospital, Geneva, Switzerland.
- Bourhis J Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois-CHUV, Lausanne, Switzerland.
- Ozsahin M Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois-CHUV, Lausanne, Switzerland.
- Zilli T Radiation Oncology Department, Geneva University Hospital, Geneva, Switzerland.
- 2018-02-15
Published in:
- Journal of cancer research and clinical oncology. - 2018
Anal cancer
Helical tomotherapy
IMRT
Local control
Toxicity
VMAT
Aged
Anus Neoplasms
Chemoradiotherapy
Female
Humans
Male
Middle Aged
Radiotherapy, Intensity-Modulated
Randomized Controlled Trials as Topic
English
PURPOSE
To report outcomes of a population of anal cancer patients treated with modern intensity-modulated radiotherapy and daily image-guided radiotherapy techniques.
METHODS
We analyzed data of 155 patients consecutively treated with intensity-modulated radiotherapy +/- chemotherapy in three radiotherapy departments. One hundred twenty-two patients presented a stage II-IIIA disease. Chemotherapy was administered in 138 patients, mainly using mitomycin C and 5-fluorouracil (n = 81). All patients received 36 Gy (1.8 Gy/fraction) on the pelvic and inguinal nodes, on the rectum, on the mesorectum and on the anal canal, and a sequential boost up to a total dose of 59.4 Gy (1.8 Gy/fraction) on the anal canal and on the nodal gross tumor volumes.
RESULTS
Median follow-up was 38 months (interquartile range 12-51). Toxicity data were available for 143 patients: 22% of them presented a G3+ acute toxicity, mainly as moist desquamation (n = 25 patients) or diarrhea (n = 10). Three patients presented a late grade 3 gastrointestinal toxicity (anal incontinence). No grade 4 acute or late toxicity was recorded. Patients treated with fixed-gantry IMRT delivered with a sliding window technique presented a significantly higher risk of acute grade 3 (or more) toxicity compared to those treated with VMAT or helical tomotherapy (38.5 vs 15.3%, p = 0.049). Actuarial 4-year local control rate was 82% (95% CI 76-91%).
CONCLUSIONS
Modern intensity-modulated radiotherapy with daily image-guided radiotherapy is effective and safe in treating anal cancer patients and should be considered the standard of care in this clinical setting.
To report outcomes of a population of anal cancer patients treated with modern intensity-modulated radiotherapy and daily image-guided radiotherapy techniques.
METHODS
We analyzed data of 155 patients consecutively treated with intensity-modulated radiotherapy +/- chemotherapy in three radiotherapy departments. One hundred twenty-two patients presented a stage II-IIIA disease. Chemotherapy was administered in 138 patients, mainly using mitomycin C and 5-fluorouracil (n = 81). All patients received 36 Gy (1.8 Gy/fraction) on the pelvic and inguinal nodes, on the rectum, on the mesorectum and on the anal canal, and a sequential boost up to a total dose of 59.4 Gy (1.8 Gy/fraction) on the anal canal and on the nodal gross tumor volumes.
RESULTS
Median follow-up was 38 months (interquartile range 12-51). Toxicity data were available for 143 patients: 22% of them presented a G3+ acute toxicity, mainly as moist desquamation (n = 25 patients) or diarrhea (n = 10). Three patients presented a late grade 3 gastrointestinal toxicity (anal incontinence). No grade 4 acute or late toxicity was recorded. Patients treated with fixed-gantry IMRT delivered with a sliding window technique presented a significantly higher risk of acute grade 3 (or more) toxicity compared to those treated with VMAT or helical tomotherapy (38.5 vs 15.3%, p = 0.049). Actuarial 4-year local control rate was 82% (95% CI 76-91%).
CONCLUSIONS
Modern intensity-modulated radiotherapy with daily image-guided radiotherapy is effective and safe in treating anal cancer patients and should be considered the standard of care in this clinical setting.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1007/s00432-018-2608-6
- PMID 29441419
- Persistent URL
- https://sonar.ch/global/documents/232661
Statistics
Document views: 18
File downloads:
- Full-text: 0