Efficacy and toxicity of chemoradiation in patients with anal cancer - a retrospective analysis

Radiation Oncology

Florian Sterzing²  Juergen Debus²  Klaus Herfarth²  Annette Kopp-Schneider¹  Kerstin Kessel³  Clara Schoneweg²  David Krug²  Matthias F Haefner²  Alla Slynko¹  Stefan Alexander Koerber² 

[1] Institute of Biostatistics, German Cancer Research Center, Heidelberg, Germany;Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center, Heidelberg, Germany;Department of Radiation Oncology, University Hospital, Heidelberg, Germany

关键词: Radiation;    3D-CRT;    IMRT;    Toxicity;    Radiochemotherapy;    Anal [canal] cancer;   

Others  :  805158
DOI  :  10.1186/1748-717X-9-113

 received in 2013-12-09, accepted in 2014-05-02,  发布年份 2014

【 摘 要 】

Background

Concurrent chemotherapy and radiation therapy is the preferred standard of care for patients with anal cancer. Several studies have suggested a benefit of intensity-modulated radiation therapy (IMRT) compared with 3D-conformal radiation (3D-CRT) regarding acute toxicity. This study evaluates outcome and toxicity of patients undergoing IMRT/Tomotherapy or 3D-CRT at our institution.

Methods

A cohort of 105 anal cancer patients was treated with chemoradiation or radiation alone (16.2%) between January 2000 and December 2011. 37 patients received 3D-CRT while 68 patients were treated with IMRT. Follow-up exams were performed every 3 to 6 months for a minimum of 3 years and then annually.

Results

Median follow-up was 41.4 months (2.8 – 158.4). Overall survival (OS), Progression-free survival (PFS) and local control (LC) at 3 years was 70.3%, 66.5%, 78.3% in the 3D-CRT group and 82.9%, 66.5%, 75.3% in the IMRT group without statistically significant difference. 3-year Colostomy-free survival (CFS) was 85.7% in the IMRT/Tomotherapy group and 91.8% in the 3D-CRT group (p = 0.48). No grade 4 toxicity was found in both groups. Severe (G2/3) acute skin toxicity (94.6% vs. 63.2%; p < 0.001) and acute gastrointestinal toxicity rate (67.6% vs. 47.1%; p = 0.03) was significantly higher with 3D-CRT compared to IMRT/Tomotherapy.

Conclusion

The use of IMRT can reduce acute severe side effects of the skin and gastrointestinal tract but did not demonstrate improved results regarding OS, PFS, LC and CFS.

【 授权许可】

   
2014 Koerber et al.; licensee BioMed Central Ltd.

【 图 表 】

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