Modern intensity-modulated radiotherapy with image guidance allows low toxicity rates and good local control in chemoradiotherapy for anal cancer patients
| Autor: | L. Lestrade, Oscar Matzinger, Berardino De Bari, Raymond Miralbell, Raphael Jumeau, Maira Biggiogero, Thomas Zilli, Mahmut Ozsahin, Melpomeni Kountouri, Alessandra Franzetti-Pellanda, Jean Bourhis |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty medicine.medical_treatment Population Rectum ddc:616.0757 Tomotherapy 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine Anal cancer Humans education Aged Randomized Controlled Trials as Topic Intensity-Modulated/adverse effects/methods education.field_of_study Radiotherapy business.industry General Medicine Chemoradiotherapy Anal canal Middle Aged medicine.disease Anus Neoplasms Radiation therapy medicine.anatomical_structure Moist desquamation Oncology 030220 oncology & carcinogenesis Female Anus Neoplasms/diagnostic imaging/drug therapy/radiotherapy Radiology Radiotherapy Intensity-Modulated business |
| Zdroj: | Journal of Cancer Research and Clinical Oncology, Vol. 144, No 4 (2018) pp. 781-789 |
| ISSN: | 1432-1335 0171-5216 |
| Popis: | To report outcomes of a population of anal cancer patients treated with modern intensity-modulated radiotherapy and daily image-guided radiotherapy techniques. We analyzed data of 155 patients consecutively treated with intensity-modulated radiotherapy +/− chemotherapy in three radiotherapy departments. One hundred twenty-two patients presented a stage II–IIIA disease. Chemotherapy was administered in 138 patients, mainly using mitomycin C and 5-fluorouracil (n = 81). All patients received 36 Gy (1.8 Gy/fraction) on the pelvic and inguinal nodes, on the rectum, on the mesorectum and on the anal canal, and a sequential boost up to a total dose of 59.4 Gy (1.8 Gy/fraction) on the anal canal and on the nodal gross tumor volumes. Median follow-up was 38 months (interquartile range 12–51). Toxicity data were available for 143 patients: 22% of them presented a G3+ acute toxicity, mainly as moist desquamation (n = 25 patients) or diarrhea (n = 10). Three patients presented a late grade 3 gastrointestinal toxicity (anal incontinence). No grade 4 acute or late toxicity was recorded. Patients treated with fixed-gantry IMRT delivered with a sliding window technique presented a significantly higher risk of acute grade 3 (or more) toxicity compared to those treated with VMAT or helical tomotherapy (38.5 vs 15.3%, p = 0.049). Actuarial 4-year local control rate was 82% (95% CI 76–91%). Modern intensity-modulated radiotherapy with daily image-guided radiotherapy is effective and safe in treating anal cancer patients and should be considered the standard of care in this clinical setting. |
| Databáze: | OpenAIRE |
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