scholarly journals 106P Efficacy and tolerability of capecitabine and mitomycin-C based concurrent radiotherapy in patients with anal canal cancer

2020 ◽  
Vol 31 ◽  
pp. S1283
Author(s):  
P.G. Bhargava ◽  
R. Engineer ◽  
A. Ramaswamy ◽  
S. Sujay Srinivas ◽  
M. Shah ◽  
...  
Keyword(s):  
Anal Canal ◽  
Mitomycin C ◽  
Anal Canal Cancer ◽  
Concurrent Radiotherapy

Induction Therapy for Poor-Prognosis Anal Canal Carcinoma: A Phase II Study of the Cancer and Leukemia Group B (CALGB 9281)

2008 ◽  
Vol 26 (19) ◽  
pp. 3229-3234 ◽  
Author(s):  
Neal J. Meropol ◽  
Donna Niedzwiecki ◽  
Brenda Shank ◽  
Thomas A. Colacchio ◽  
John Ellerton ◽  
...  
Keyword(s):  
Anal Canal ◽  
Mitomycin C ◽  
Poor Prognosis ◽  
Combined Modality Therapy ◽  
Induction Treatment ◽  
Anal Canal Cancer ◽  
Combined Modality ◽  
Bulky N2 ◽  
Disease Free ◽  
Patients With Poor Prognosis

PurposeAlthough most patients with anal canal cancer are cured with sphincter-preserving, nonsurgical, combined-modality therapy, those with large tumors and lymph node involvement have a poor prognosis. To establish the safety and efficacy of induction chemotherapy with infusional fluorouracil (FU) plus cisplatin followed by FU plus mitomycin C with concurrent radiation in patients with poor-prognosis squamous cell cancers of the anal canal.MethodsPatients with previously untreated anal canal cancers with T3 or T4 tumors and/or extensive nodal involvement (bulky N2 or N3) received two 28-day cycles of induction treatment with infusional FU plus cisplatin followed by two 28-day cycles of FU plus mitomycin C with concurrent split-course radiation. A third cycle of FU and cisplatin with radiation boost was given to patients with persistent primary site disease or bulky N2 or N3 disease at presentation.ResultsForty-five assessable patients received protocol therapy. Treatment was generally well tolerated, and gastrointestinal and hematologic toxicities were the most common. Induction chemotherapy resulted in eight complete and 21 partial responses. After induction, combined-modality, and boost therapy, 37 (82%) of 45 assessable high-risk patients achieved a complete response. After 4 years of follow-up, 68% of patients are alive, 61% are disease-free, and 50% are colostomy- and disease-free.ConclusionA combined-modality approach that includes induction treatment with FU and cisplatin followed by combined-modality therapy with FU, mitomycin C, and concurrent radiation results in long-term disease control in the majority of patients with poor-prognosis anal canal cancer.

Two-year outcomes of RTOG 0529: A phase II evaluation of dose-painted IMRT in combination with 5-fluorouracil and mitomycin-C for the reduction of acute morbidity in carcinoma of the anal canal.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 368-368 ◽  
Author(s):  
L. A. Kachnic ◽  
K. A. Winter ◽  
R. J. Myerson ◽  
M. D. Goodyear ◽  
J. Willins ◽  
...  
Keyword(s):  
Acute Toxicity ◽  
Anal Canal ◽  
Mitomycin C ◽  
Anal Cancer ◽  
Second Primary ◽  
Anal Canal Cancer ◽  
Kaplan Meier ◽  
Conventional Radiation ◽  
Target Volumes ◽  
Grade 3

368 Background: 5-Fluorouracil (5FU) and mitomycin-C (MMC) chemoradiation for anal cancer is associated with high rates of acute morbidity. We have previously shown that dose-painted IMRT (DP-IMRT) significantly reduces grade 3+ GI and dermatologic acute toxicity, as compared to the RTOG 9811 5FU/MMC arm, which used non-conformal radiation techniques. We now report on the two-year outcomes of this DP-IMRT approach. Methods: T2-4N0-3M0 anal canal cancers received 5FU (1,000 mg/m2/day 96 hour infusion) and MMC (10 mg/m2 bolus) days 1 and 29 of DP-IMRT prescribed as follows - T2N0: 42 Gy elective nodal and 50.4 Gy anal tumor planning target volumes (PTVs), 28 fractions; T3-4N0-3: 45 Gy elective nodal, 50.4 Gy ≤ 3 cm and 54 Gy > 3 cm metastatic nodal and 54 Gy anal tumor PTVs, 30 fractions. The following two-year outcomes were assessed: local-regional (LRF) and colostomy failures (CF) using the cumulative incidence method, and disease-free (DFS), overall (OS) and colostomy-free survivals (CFS) using the Kaplan-Meier method. Results: Of 63 accrued patients, 52 were analyzable. Median age was 58 years; 81% female; 54% stage II; 25% IIIA; 21% IIIB. Median follow-up was 23.2 months (0.2-33). Two-year LRF, CF, DFS and 95% confidence intervals are 20% (9%, 31%), 8% (0.4%, 15%) and 77% (62%, 86%), respectively. The causes of death for the 7 patients that died are: anal cancer in 5, morbidity in one and second primary outside the radiation field in one. Two-year comparison data from the RTOG 9811 5FU/MMC arm are shown in the table below. Conclusions: DP-IMRT with 5FU/MMC for the treatment of anal canal cancer yields similar two-year outcomes as the RTOG 9811 conventional radiation, 5FU/MMC arm. Because of the associated acute toxicity sparing, DP-IMRT will be used as the platform, and may allow for radiation dose escalation, in future RTOG anal canal trials. Supported by RTOG U10 CA21661, CCOP U10 CA3742 and ATC U24 CA 81647 NCI grants. [Table: see text] No significant financial relationships to disclose.

Concurrent Chemotherapy and Intensity-Modulated Radiation Therapy for Anal Canal Cancer Patients: A Multicenter Experience

2007 ◽  
Vol 25 (29) ◽  
pp. 4581-4586 ◽  
Author(s):  
Joseph K. Salama ◽  
Loren K. Mell ◽  
David A. Schomas ◽  
Robert C. Miller ◽  
Kiran Devisetty ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Anal Canal ◽  
Cancer Patients ◽  
Intensity Modulated Radiation Therapy ◽  
Complete Response ◽  
Concurrent Chemotherapy ◽  
Hiv Positive ◽  
Anal Canal Cancer ◽  
Intensity Modulated ◽  
Dermatologic Toxicity

PurposeTo report a multicenter experience treating anal canal cancer patients with concurrent chemotherapy and intensity-modulated radiation therapy (IMRT).Patients and MethodsFrom October 2000 to June 2006, 53 patients were treated with concurrent chemotherapy and IMRT for anal squamous cell carcinoma at three tertiary-care academic medical centers. Sixty-two percent were T1-2, and 67% were N0; eight patients were HIV positive. Forty-eight patients received fluorouracil (FU)/mitomycin, one received FU/cisplatin, and four received FU alone. All patients underwent computed tomography–based treatment planning with pelvic regions and inguinal nodes receiving a median of 45 Gy. Primary sites and involved nodes were boosted to a median dose of 51.5 Gy. All acute toxicity was scored according to the Common Terminology Criteria for Adverse Events, version 3.0. All late toxicity was scored using Radiation Therapy Oncology Group criteria.ResultsMedian follow-up was 14.5 months (range, 5.2 to 102.8 months). Acute grade 3+ toxicity included 15.1% GI and 37.7% dermatologic toxicity; all acute grade 4 toxicities were hematologic; and acute grade 4 leukopenia and neutropenia occurred in 30.2% and 34.0% of patients, respectively. Treatment breaks occurred in 41.5% of patients, lasting a median of 4 days. Forty-nine patients (92.5%) had a complete response, one patient had a partial response, and three had stable disease. All HIV-positive patients achieved a complete response. Eighteen-month colostomy-free survival, overall survival, freedom from local failure, and freedom from distant failure were 83.7%, 93.4%, 83.9%, and 92.9%, respectively.ConclusionPreliminary outcomes suggest that concurrent chemotherapy and IMRT for anal canal cancers is effective and tolerated favorably compared with historical standards.

Induction Chemotherapy in Patients With Anal Canal Cancer: A Pilot Study

2020 ◽  
Vol 19 (3) ◽  
pp. e137-e139
Author(s):  
Francesca De Felice ◽  
Daniela Musio ◽  
Vincenzo Tombolini
Keyword(s):  
Pilot Study ◽  
Anal Canal ◽  
Induction Chemotherapy ◽  
Anal Canal Cancer

scholarly journals Clinical case of a metastatic squamous anal canal cancer with benefit of Cetuximab - What do we know about anti EGFR?

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Losada B ◽  
Pulido G ◽  
Cervera R ◽  
Ibeas P ◽  
Perezagua C
Keyword(s):  
Anal Canal ◽  
Clinical Case ◽  
Anal Canal Cancer

scholarly journals Carcinoma of the anal canal

2011 ◽  
Vol 3 (1) ◽  
pp. 27
Author(s):  
David T. Marshall ◽  
Charles R. Thomas Jr
Keyword(s):  
Anal Canal ◽  
Locally Advanced ◽  
The United States ◽  
Sphincter Preservation ◽  
Tumor Control ◽  
Anal Canal Cancer ◽  
Permanent Colostomy ◽  
Anti Cancer ◽  
Treatment Paradigm ◽  
Technological Developments

There are around 5,000 new cases of anal canal cancer each year in the United States. It is of particular risk in HIV-positive populations. Many cases are related to persistent infection with human papillomavirus (HPV). The treatment of anal cancer has progressed from abdominoperineal resection mandating permanent colostomy in the 1940s through the 1970s to modern chemoradiation with sphincter preservation in around 80% of patients, even with locally advanced disease. The evolution of the treatment paradigm of this disease is a model for the treatment of malignant disease with organ preservation. Multiple randomized trials have been conducted to guide this evolution. Technological developments in the delivery of radiotherapy and anti-cancer pharmaceuticals harbor hope for further improvements in outcomes with possible reductions in toxicity and increases in tumor control. Perhaps most inspiring is the recent development of HPV vaccines that

scholarly journals Clinicopathological studies of anal canal cancer.

1989 ◽  
Vol 22 (10) ◽  
pp. 2414-2420 ◽  
Author(s):  
Ken HAYASHI ◽  
Teruyuki HIROTA ◽  
Masayuki ITABASHI ◽  
Keiichi HOJO ◽  
Yoshihiro MORIYA ◽  
...  
Keyword(s):  
Anal Canal ◽  
Anal Canal Cancer
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