Mitomycin-C- or Cisplatin-Based Chemoradiotherapy for Anal Canal Carcinoma: Long-Term Results

Journal Article · Tue Feb 01 00:00:00 EST 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.11.057· OSTI ID:21491589

Cabral, Vania ^[1]; Rosa, Arthur; Bezerra, Marcos; Santarem, Erick; Fassizoli, Ana ^[2]; Castro, Leonaldson; Simoes, Jose Humberto ^[3]; Small, Isabele A; Ferreira, Carlos Gil ^[4]

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1. Division of Clinical Oncology, Hospital do Cancer, Instituto Nacional de Cancer, Rio de Janeiro (Brazil)
2. Division of Radiation Oncology, Hospital do Cancer, Instituto Nacional de Cancer, Rio de Janeiro (Brazil)
3. Department of Surgical Oncology, Hospital do Cancer, Instituto Nacional de Cancer, Rio de Janeiro (Brazil)
4. Division of Clinical and Translational Research, Research Coordination, Instituto Nacional de Cancer, Rio de Janeiro (Brazil)

Purpose: To evaluate the long-term efficacy of concurrent radiotherapy with mitomycin-C (MMC)-based or cisplatin (CP)-based combinations in a cohort of patients with locally advanced anal canal carcinoma. Methods and Materials: Between 1988 and 2000, 179 patients with locally advanced anal canal carcinoma were treated at the Instituto Nacional de Cancer with two cycles of chemotherapy during Weeks 1 and 5 of radiotherapy. 5-Fluorouracil (750 mg/m{sup 2} 120-hour infusion or 1,000 mg/m{sup 2} 96-hour infusion) plus CP (100 mg/m{sup 2}) on the first day of each cycle or MMC (10-15 mg/m{sup 2}) on the first day of Cycle 1 was administered concurrent with radiotherapy (total dose, 55-59.4 Gy). Of the 179 patients, 60% were included from a randomized trial initiated at the Instituto Nacional de Cancer in 1991 that compared concurrent chemoradiotherapy with MMC vs. CP. Results: The median follow-up for the whole chemoradiotherapy group was 83 months. The median patient age was 58 years, 57% had Stage T3-T4 tumors, and 35% had N-positive disease. The 5-year cumulative colostomy rate was not significantly different between the CP group (22%) and MMC group (29%; p = .28). The actuarial 10-year overall survival and disease-free survival rate for the CP group was 54% and 49% and for the MMC group was 52% and 53%, respectively (p = .32 and p = .92, respectively). On multivariate analysis, male gender (p = .042) and advanced Stage T3-T4 disease (p <.0001) were statistically significant for worse disease-free survival. Stage T3-T4 (p = .039) and N+ (p = .039) disease remained independently significant for overall survival. Conclusion: Long-term follow-up has confirmed the good results of chemoradiotherapy with CP plus 5-fluorouracil, which seem to provide results equivalent to those with MMC plus 5-fluorouracil.

• OSTI ID: 21491589
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 79, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2009.11.057; PII: S0360-3016(09)03631-1; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
COMBINED THERAPY
MITOMYCIN
RECTUM
URACILS
ANTIBIOTICS
ANTI-INFECTIVE AGENTS
ANTIMITOTIC DRUGS
ANTINEOPLASTIC DRUGS
AZINES
BODY
DIGESTIVE SYSTEM
DISEASES
DRUGS
GASTROINTESTINAL TRACT
HETEROCYCLIC COMPOUNDS
HYDROXY COMPOUNDS
INTESTINES
LARGE INTESTINE
MEDICINE
NEOPLASMS
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PYRIMIDINES
THERAPY