IMRT for locally advanced anal cancer: clinical experience of the Montpellier Cancer Center

Radiation Oncology

David Azria¹  Norbert Aillères¹  Jean-Bernard Dubois¹  Sophie Gourgou²  Carmen Llacer Moscardo¹  Claire Lemanski¹  Pascal Fenoglietto¹  Sabine Vieillot¹ 

[1] Département de Cancérologie Radiothérapie, CRLC Val d'Aurelle-Paul Lamarque, Montpellier, France;Unité de Biostatistiques, CRLC Val d'Aurelle-Paul Lamarque, Montpellier, France

关键词: Late toxicity;    Acute toxicity;    Anal canal cancer;    IMRT;   

Others  :  1160871
DOI  :  10.1186/1748-717X-7-45

 received in 2011-11-04, accepted in 2012-03-23,  发布年份 2012

【 摘 要 】

Purpose

To assess outcomes of patients with carcinoma of the anal canal (CAC) treated with intensity-modulated radiation therapy (IMRT).

Method and materials

From August 2007 to January 2011, seventy-two patients suffering from CAC were treated with IMRT. Concurrent chemotherapy was added in case of locally advanced tumors. Radiation course consisted in delivering an initial plan to the PTV1 defined as the primary tumor and the risk area including pelvic and inguinal nodes. Forty-five Gy in daily 1.8 Gy-daily fractions were delivered five days a week. A second plan of 14.4-20 Gy to the primary tumor (PTV2) was administered in 1.8-2 Gy-daily fractions, 5 days a week. We present here the results of dosimetry, toxicities, and clinical outcome of the first 39 patients with a median follow-up of 24 months.

Results

Thirty-one women and eight men were included in the present analysis. Tumors were classified as stages I, II, III and IV in 2, 7, 27 and 2 patients, respectively. Median age was 59 years (range, 38-85). Radiotherapy alone (RT) or combined with chemotherapy (RCT) were delivered in 6 (15%) and 33 (85%) patients, respectively.

Six patients (15%) required a treatment break ≥ 3 days, and median time for treatment break was 8 days (range, 3-14 days). Acute grade 3 gastrointestinal (GI) and genitourinary (GU) toxicities were seen in 10 and 5% of patients, respectively. Grade 4 toxicity was only hematologic and occurred in 12% patients receiving RCT. With a median follow-up of 24 months, no patient experienced any late grade 4 toxicity. The 2-year overall survival rate was 89%, the 2-year local relapse free survival was 77% and the 2-year colostomy-free survival rate was 85%.

Conclusion

IMRT is well tolerated with acceptable treatment interruption allowing dose escalation.

【 授权许可】

   
2012 Vieillot et al; licensee BioMed Central Ltd.

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