Role of brachytherapy in the treatment of cancers of the anal canal. Long-term follow-up and multivariate analysis of a large monocentric retrospective series

Autor: Pascal Pommier, Jean-Michel Ardiet, Christian Carrie, X. Montbarbon, Berardino De Bari, Emilie Lavergne, L. Lestrade
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Adult
Male
Oncology
medicine.medical_specialty
Multivariate analysis
medicine.medical_treatment
Brachytherapy
ECOG Performance Status
Disease-Free Survival
Aged
Aged
80 and over
Anus Neoplasms/drug therapy
Anus Neoplasms/mortality
Brachytherapy/methods
Chemoradiotherapy
Colostomy
Combined Modality Therapy
Female
Follow-Up Studies
Humans
Lymphatic Metastasis/pathology
Lymphatic Metastasis/radiotherapy
Middle Aged
Multivariate Analysis
Neoplasm Staging
Radiation Injuries/etiology
Radiation Injuries/surgery
Retrospective Studies
Internal medicine
medicine
Radiology
Nuclear Medicine and imaging
External beam radiotherapy
Radiation Injuries
Chemotherapy
Univariate analysis
business.industry
Anal canal
Anus Neoplasms
Radiation therapy
medicine.anatomical_structure
Lymphatic Metastasis
Radiology
business
Zdroj: Strahlentherapie Und Onkologie, vol. 190, no. 6, pp. 546-554
Popis: BACKGROUND AND PURPOSE: There are few data on long-term clinical results and tolerance of brachytherapy in anal canal cancer. We present one of the largest retrospective analyses of anal canal cancers treated with external beam radiotherapy with/without (±) chemotherapy followed by a brachytherapy boost. MATERIALS AND METHODS: We performed a retrospective analysis of clinical results in terms of efficacy and toxicity. The impact of different clinical and therapeutic variables on these outcomes was studied. RESULTS: From May 1992 to December 2009, 209 patients received brachytherapy after external beam radiotherapy ± chemotherapy. Of these patients, 163 were stage II or stage IIIA (UICC 2002) and 58 were N1-3. According to age, ECOG performance status (PS), and comorbidities, patients received either radiotherapy alone (58/209) or radiochemotherapy (151/209). The median follow-up was 72.8 months. The 5- and 10-year local control rates were 78.6 and 73.9 %, respectively. Globally, severe acute and late G3-4 reactions (NCI-CTC scale v. 4.0) occurred in 11.2 and 6.3 % of patients, respectively. Univariate analysis showed the statistical impact of the pelvic treatment volume (p = 0.046) and of the total dose (p = 0.02) on the risk of severe acute and late toxicities, respectively. Only six patients required permanent colostomy because of severe late anorectal toxicities. CONCLUSION: After a long follow-up time, brachytherapy showed an acceptable toxicity profile and high local control rates in patients with anal canal cancer.
Databáze: OpenAIRE
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