scholarly journals Anal Cancer: Clinical Outcomes, Toxicities, and Colostomy Free Survival Comparing 3-D Conformal Radiation Therapy (3DCRT) Versus Intensity Modulated Radiation Therapy (IMRT) Techniques

2015 ◽  
Vol 93 (3) ◽  
pp. E120
Author(s):  
G.A. Ferraris ◽  
M. F. Diaz Vazquez ◽  
M. Ferraris ◽  
S.E. Finkelstein ◽  
E. Fernandez
Keyword(s):  
Radiation Therapy ◽  
Clinical Outcomes ◽  
Anal Cancer ◽  
Intensity Modulated Radiation Therapy ◽  
Conformal Radiation Therapy ◽  
Free Survival ◽  
Intensity Modulated

Intensity-modulated radiation therapy versus 3D conformal radiation therapy for squamous cell carcinoma of the anal canal.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 494-494 ◽  
Author(s):  
Michael Chuong ◽  
Jessica Freilich ◽  
Sarah Hoffe ◽  
William J. Fulp ◽  
Jill Weber ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Anal Cancer ◽  
Intensity Modulated Radiation Therapy ◽  
Long Term Outcomes ◽  
Conformal Radiation Therapy ◽  
Free Survival ◽  
Intensity Modulated ◽  
3D Conformal Radiation Therapy ◽  
Grade 3

494 Background: The emergence of intensity-modulated radiation therapy (IMRT) in the treatment of anal cancer has dramatically lowered the incidence of severe toxicity while maintaining excellent long-term outcomes. We compared our institutional experience using 3D conformal radiation therapy (3DCRT) versus IMRT for anal cancer. Methods: We performed a single-institution retrospective review of all non-metastatic squamous cell carcinoma anal cancer patients treated between 2000-2011 using definitive chemoradiation with curative intent. Results: This study included 89 consecutive anal cancer patients (37 3DCRT, 52 IMRT). Median follow-up for all patients, IMRT patients alone, and CRT patients alone was 26.5 months (range, 3.5-133.6), 20 months (range, 3.5-125.5), and 61.9 months (range, 7.6-133.6), respectively. Three-year overall survival (OS), progression free survival (PFS), locoregional control (LRC), and colostomy free survival (CFS) were 91.1%, 82.3%, 90.8%, and 91.3% in the IMRT cohort and 86.1%, 72.5%, 91.9%, and 93.7% for the 3DCRT patients (all p>0.1). More patients in the 3DCRT group required a treatment break (11 vs. 4; p=0.006), although the difference in median treatment break duration was not significant (12.2 vs. 8.0 days; p=0.35). Survival outcomes did not differ based on whether a treatment break was required (all p>0.1). Acute grade ≥3 non-hematologic toxicity was significantly decreased in the IMRT cohort (21.1 vs. 59.5%; p<0.0001). Acute grade ≥3 skin toxicity was significantly worse in the 3DCRT group (p<0.0001) while an improvement in late grade ≥3 GI toxicity was observed in the IMRT patients (p=0.012). Conclusions: This is the largest retrospective review comparing 3DCRT and IMRT for definitive treatment of anal cancer. In contrast to previously published data, this study demonstrates that while long-term outcomes do not significantly differ based on RT technique, a marked decrease in adverse effects and the need for a treatment break can be achieved using IMRT.

scholarly journals Toxicity and survival of anal cancer patients treated with intensity-modulated radiation therapy

2019 ◽  
Vol 101 (3) ◽  
pp. 168-175 ◽  
Author(s):  
A Ghareeb ◽  
K Paramasevon ◽  
P Mokool ◽  
H van der Voet ◽  
M Jha
Keyword(s):  
Radiation Therapy ◽  
Cancer Patients ◽  
Anal Cancer ◽  
Intensity Modulated Radiation Therapy ◽  
University Hospital ◽  
Conventional Radiotherapy ◽  
Free Survival ◽  
James Cook ◽  
Intensity Modulated

Introduction The definitive treatment of anal cancer with chemoradiotherapy spares abdominoperineal resection for salvage treatment but carries a high burden of toxicity. Intensity-modulated radiation therapy has been implemented to reduce toxicity, reduce treatment breaks and improve survival. However, large and long-term studies are lacking. We aimed to investigate the toxicities and long-term survival of anal cancer patients treated with intensity-modulated radiation therapy at James Cook University Hospital, Middlesbrough. Materials and methods We conducted a retrospective analysis of all patients with squamous cell anal cancer treated at James Cook University Hospital between July 2010 and April 2017. All patients were uniformly treated with intensity-modulated radiation therapy-based chemoradiation with curative intent. A subset of these patients was followed-up prospectively by an oncologist for acute and late toxicity. We calculated Kaplan–Meier estimates of survival statistics and compared our results with those of previous trials which used conventional radiotherapy. Results We studied 132 patients, including a toxicity subset of 64, for a median follow-up time of 43 months (range 3–84 months). Eleven patients (8.3%) underwent salvage abdominoperineal resection. Grade 3+ acute non-haematological, gastrointestinal, genitourinary and dermatological toxicity were found in 56.2%, 12.3%, 0% and 50.7% of the toxicity subset (n = 64). Median treatment duration was 37 days. Overall and colostomy-free survival at five years were 68.3% and 85.3%, respectively. Tumour size (P = 0.006) and age (P = 0.002) predicted shorter overall survival. Conclusions Intensity-modulated radiation therapy probably reduces acute gastrointestinal and genitourinary toxicity compared with conventional radiotherapy, while resulting in similar overall and colostomy-free survival. We suggest that further dose escalation may improve survival in patients with T3/T4 tumours.

scholarly journals Radiotherapy with Intensity-Modulated (IMRT) Techniques in the Treatment of Anal Carcinoma (RAINSTORM): A Multicenter Study on Behalf of AIRO (Italian Association of Radiotherapy and Clinical Oncology) Gastrointestinal Study Group

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1902
Author(s):  
Luciana Caravatta ◽  
Giovanna Mantello ◽  
Francesca Valvo ◽  
Pierfrancesco Franco ◽  
Lucrezia Gasparini ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Clinical Outcomes ◽  
Anal Cancer ◽  
Treatment Time ◽  
Histological Grade ◽  
Anal Carcinoma ◽  
Nodal Involvement ◽  
Free Survival ◽  
Intensity Modulated ◽  
Grade 3

A multi-institutional retrospective study was conducted to evaluate the pattern of care and clinical outcomes of anal cancer patients treated with intensity-modulated radiotherapy (IMRT) techniques. In a cohort of 987 patients, the clinical complete response (CR) rate (beyond 6 months) was 90.6%. The 3-year local control (LC) rate was 85.8% (95% CI: 84.4–87.2), and the 3-year colostomy-free survival (CFS) rate was 77.9% (95% CI: 76.1–79.8). Three-year progression-free survival (PFS) and overall survival (OS) rates were 80.2% and 88.1% (95% CI: 78.8–89.4) (95% CI: 78.5–81.9), respectively. Histological grade 3 and nodal involvement were associated with lower CR (p = 0.030 and p = 0.004, respectively). A statistically significant association was found between advanced stage and nodal involvement, and LC, CFS, PFS, OS and event-free survival (EFS). Overall treatment time (OTT) ≥45 days showed a trend for a lower PFS (p = 0.050) and was significantly associated with lower EFS (p = 0.030) and histological grade 3 with a lower LC (p = 0.025). No statistically significant association was found between total dose, dose/fraction and/or boost modality and clinical outcomes. This analysis reports excellent clinical results and a mild toxicity profile, confirming IMRT techniques as standard of care for the curative treatment of anal cancer patients. Lymph node involvement and histological grade have been confirmed as the most important negative prognostic factors.

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