Intensity modulated radiotherapy for anal canal squamous cell carcinoma: A 16-year single institution experience
| Autor: | Christopher L. Hallemeier, Joleen M. Hubbard, Harigopal Sandhyavenu, A.E. Garda, William G. Breen, Karthik Gonuguntla, David M. Routman, Kenneth W. Merrell, Michael G. Haddock, Michelle A. Neben-Wittich, William S. Harmsen, Krishan R. Jethwa, Courtney N. Day, Thorvardur R. Halfdanarson |
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| Rok vydání: | 2021 |
| Předmět: |
R895-920
LRR locoregional recurrence RT radiotherapy DP-IMRT dose-painted intensity modulated radiotherapy Gastroenterology 030218 nuclear medicine & medical imaging Medical physics. Medical radiology. Nuclear medicine CFS colostomy-free survival 0302 clinical medicine Interquartile range Medicine Cumulative incidence DVH dose-volume histogram CTV clinical target volume RC254-282 DM distant metastasis Anal canal squamous cell carcinoma Radiation RTOG Radiation Therapy Oncology Group Hazard ratio Neoplasms. Tumors. Oncology. Including cancer and carcinogens MMC mitomycin-C CTCAE v 4.0 common terminology criteria for adverse events version 4.0 ACT II United Kingdom Anal Cancer Trial II IMRT intensity modulated radiotherapy GI gastrointestinal PFS progression-free survival HIV human immunodeficiency virus Oncology 030220 oncology & carcinogenesis PTV planning target volume medicine.medical_specialty BED biologically effective dose Article OS overall survival 03 medical and health sciences AE adverse events Internal medicine Anal cancer Radiology Nuclear Medicine and imaging Progression-free survival IMRT IQR interquartile range LR local recurrence business.industry medicine.disease CRT chemoradiotherapy HR hazard ratio ASCC anal canal squamous cell carcinoma Confidence interval CI confidence interval 3DCRT 3-dimensional conformal radiotherapy G grade LN lymph node 5-FU 5-fluorouracil GU genitourinary business Chemoradiotherapy |
| Zdroj: | Clinical and Translational Radiation Oncology Clinical and Translational Radiation Oncology, Vol 28, Iss, Pp 17-23 (2021) |
| ISSN: | 2405-6308 |
| DOI: | 10.1016/j.ctro.2021.02.002 |
| Popis: | Highlights • IMRT is associated with favorable toxicity rates for patients with anal cancer. • Outcomes were favorable for those with T3-4 tumors or lymph node involvement. • Current smokers are at a higher risk of severe dermatologic toxicity. • Overall treatment duration greater than 39 days is associated with recurrence. Introduction To report long-term efficacy and adverse events (AEs) associated with intensity modulated radiotherapy (IMRT) for patients with anal canal squamous cell carcinoma (ASCC). Materials and methods This was a retrospective review of patients with ASCC who received curative-intent IMRT and concurrent chemotherapy (98%) between 2003 and 2019. Overall survival (OS), colostomy-free survival (CFS), and progression-free survival (PFS) were estimated using the Kaplan-Meier method. The cumulative incidence of local recurrence (LR), locoregional recurrence (LRR), and distant metastasis (DM) were reported. Acute and late AEs were recorded per National Cancer Institute Common Terminology Criteria for AEs. Results 127 patients were included. The median patient age was 63 years (interquartile range [IQR] 55–69) and 79% of patients were female. 33% of patients had T3-4 disease and 68% had clinically involved pelvic or inguinal lymph nodes (LNs). The median patient follow-up was 47 months (IQR: 28–89 months). The estimated 4-year OS, CFS, and PFS were 81% (95% confidence interval [CI]: 73%–89%), 77% (95% CI: 68%–86%), and 78% (95% CI: 70%–86%), respectively. The 4-year cumulative incidences of LR, LRR, and DM were 3% (95% CI: 1%–9%), 9% (95% CI: 5%–17%), and 10% (95% CI: 6%–18%), respectively. Overall treatment duration greater than 39 days was associated with an increased risk of LRR (Hazard Ratio [HR]: 5.2, 95% CI: 1.4–19.5, p = 0.015). The most common grade 3+ acute AEs included hematologic (31%), gastrointestinal (GI) (17%), dermatologic (16%), and pain (15%). Grade 3+ late AEs included: GI (3%), genitourinary (GU) (2%), and pain (1%). Current smokers were more likely to experience grade 3+ acute dermatologic toxicity compared to former or never smokers (34% vs. 7%, p |
| Databáze: | OpenAIRE |
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