Can laser therapy be the answer for radiodermatitis in anal cancer patients? Two case reports

SummaryHematopoietic colony-stimulating factors (CSFs) are largely used in patients with cancer undergoing cytotoxic treatment to accelerate neutrophil recovery and decrease the incidence of febrile neutropenia. Clinical practice guidelines for their use have been recently established (1), taking into account clinical benefit, but also cost and toxicity. Vascular occlusions have been recently reported among the severe reactions associated with the use of CSFs, in anedoctal case reports (2, 3), consecutive case series (4) and randomized clinical trial (5, 6). However, the role of CSFs in the pathogenesis of thrombotic complications is difficult to ascertain, because pertinent data are scanty and widely distributed over a number of heterogenous investigations. We report here a systematic review of relevant articles, with the aims to estimate the prevalence of thrombosis associated with the use of CSFs and to assess if this rate is significantly higher than that observed in cancer patients not receiving CSFs.

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Intrafractional Vaginal Dilation in Anal Cancer Patients Undergoing Pelvic Radiotherapy

Case Medical Research ◽

10.31525/ct1-nct04094454 ◽

2019 ◽

Author(s):

Keyword(s):

Cancer Patients ◽

Anal Cancer ◽

Pelvic Radiotherapy

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The Prognostic Value of the New Combined Hemo-Eosinophil Inflammation Index (HEI Index): A Multicenter Analysis of Anal Cancer Patients Treated with Concurrent Chemo-Radiation

Cancers ◽

10.3390/cancers13040671 ◽

2021 ◽

Vol 13 (4) ◽

pp. 671

Author(s):

Margherita Rimini ◽

Pierfrancesco Franco ◽

Berardino De Bari ◽

Maria Giulia Zampino ◽

Stefano Vagge ◽

...

Keyword(s):

High Risk ◽

Cancer Patients ◽

Anal Cancer ◽

Prognostic Score ◽

Univariate Analysis ◽

External Validation ◽

Risk Groups ◽

Anal Squamous Cell Carcinoma ◽

Predictors Of Response ◽

Risk Patients

Anal squamous cell carcinoma (SCC) is a rare tumor, and bio-humoral predictors of response to chemo-radiation (CT-RT) are lacking. We developed a prognostic score system based on laboratory inflammation parameters. We investigated the correlation between baseline clinical and laboratory variables and disease-free (DFS) and overall (OS) survival in anal SCC patients treated with CT-RT in five institutions. The bio-humoral parameters of significance were included in a new scoring system, which was tested with other significant variables in a Cox’s proportional hazard model. A total of 308 patients was included. We devised a prognostic model by combining baseline hemoglobin level, SII, and eosinophil count: the Hemo-Eosinophils Inflammation (HEI) Index. We stratified patients according to the HEI index into low- and high-risk groups. Median DFS for low-risk patients was not reached, and it was found to be 79.5 months for high-risk cases (Hazard Ratio 3.22; 95% CI: 2.04–5.10; p < 0.0001). Following adjustment for clinical covariates found significant at univariate analysis, multivariate analysis confirmed the HEI index as an independent prognostic factor for DFS and OS. The HEI index was shown to be a prognostic parameter for DFS and OS in anal cancer patients treated with CT-RT. An external validation of the HEI index is mandatory for its use in clinical practice.

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Effectiveness of low level laser therapy versus cryotherapy in cancer patients with oral mucositis: Systematic review and network meta-analysis

Critical Reviews in Oncology/Hematology ◽

10.1016/j.critrevonc.2021.103276 ◽

2021 ◽

Vol 160 ◽

pp. 103276

Author(s):

Chih-Chin Lai ◽

Shiau-Yee Chen ◽

Yu-Kang Tu ◽

Yu-Wei Ding ◽

Jiu-Jenq Lin

Keyword(s):

Systematic Review ◽

Cancer Patients ◽

Laser Therapy ◽

Oral Mucositis ◽

Meta Analysis ◽

Low Level Laser Therapy ◽

Low Level ◽

Low Level Laser ◽

Level Laser

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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 ◽

10.3390/cancers13081902 ◽

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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The Volume of PET-Defined, Active Bone Marrow Spared Predicts Acute Hematologic Toxicities in Anal Cancer Patients Receiving Concurrent Chemoradiation Therapy

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2017.06.956 ◽

2017 ◽

Vol 99 (2) ◽

pp. E148-E149 ◽

Cited By ~ 2

Author(s):

C. Freese ◽

M. Sudhoff ◽

L.M. Lewis ◽

M.A.S. Lamba ◽

J.R. Kharofa

Keyword(s):

Bone Marrow ◽

Cancer Patients ◽

Anal Cancer ◽

Chemoradiation Therapy ◽

Concurrent Chemoradiation ◽

Concurrent Chemoradiation Therapy

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Long-Term Outcomes of Chemoradiation for Anal Cancer Patients

Yonsei Medical Journal ◽

10.3349/ymj.2013.54.1.108 ◽

2013 ◽

Vol 54 (1) ◽

pp. 108 ◽

Cited By ~ 6

Author(s):

Hun Jin Kim ◽

Jung Wook Huh ◽

Chang Hyun Kim ◽

Sang Woo Lim ◽

Taek-Keun Nam ◽

...

Keyword(s):

Cancer Patients ◽

Anal Cancer ◽

Long Term Outcomes

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Systemic Capillary Leak Syndrome (Clarkson Syndrome) in Cancer Patients: A Systematic Review

Journal of Clinical Medicine ◽

10.3390/jcm7110418 ◽

2018 ◽

Vol 7 (11) ◽

pp. 418 ◽

Cited By ~ 2

Author(s):

Jae Shin ◽

Keum Lee ◽

I. Lee ◽

Ji Oh ◽

Dong Kim ◽

...

Keyword(s):

Cancer Patients ◽

Case Reports ◽

Laboratory Data ◽

Capillary Leak Syndrome ◽

Treatment Modalities ◽

Capillary Leak ◽

Contributing Factors ◽

Systemic Capillary Leak Syndrome ◽

Increased Risk ◽

Anti Cancer

Systemic capillary leak syndrome (SCLS) is a rare disease characterized by shock caused by capillary hyperpermeability. The disease can occur in cancer patients and effective therapeutic strategies have not been established yet. The aim of the study was to analyze the clinical and laboratory data, treatment modalities, and mortality rate of patients and to identify contributing factors leading to mortality of SCLS in cancer. We searched MEDLINE (inception to July 2018) and of 4612 articles, we identified 62 case reports on SCLS associated with cancer or cancer-related drugs in a total of 53 articles. SCLS was associated with cancer itself in 43.6%, with anti-cancer agents in 51.6% and bone marrow transplantation (BMT) in 4.8%. Among anti-cancer agents, granulocyte-colony stimulating factor (G-CSF) was the most frequently associated drug (14.6%), followed by interleukin (IL)-2 (11.4%). The most common associated malignancies were hematologic (61.3%) with non-Hodgkin lymphoma (22.7%) and multiple myeloma (12.9%) being the leading causes. Common symptoms and signs included dyspnea (27.4%), edema (67.7%), hypotension (32.2%), pleural effusion (29.0%), ascites (22.7%), oliguria (22.7%), and weight gain (21.0%). Patients with SCLS were treated with steroids (59.7%), volume replacement (33.8%), diuretics (24.2%), inotropes (9.6%), methylxanthines (12.8%), β2 agonists (4.8%), while intravenous immunoglobulins (IVIG) were administered in 2 patients (3.2%) only. Among sixteen deaths during follow-up, four were directly attributed to SCLS. Hematologic malignancies were associated with an increased risk for mortality (hazard ratio (HR) 8.820, 95% confidence interval (CI) 1.126–69.063, p = 0.038). Taken together, SCLS can be one important adverse event in cancer patients and careful monitoring of fluid volume is required in the management of SCLS.

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