High-Grade Acute Organ Toxicity as a Positive Prognostic Factor in Primary Radiochemotherapy for Anal Carcinoma

Journal Article · Fri Apr 01 00:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.01.010· OSTI ID:21491687

Wolff, Hendrik Andreas; Raus, Ismene ^[1]; Jung, Klaus ^[2]; Schueler, Phillip ^[3]; Herrmann, Markus Karl; Hennies, Steffen; Vorwerk, Hilke; Hille, Andrea; Hess, Clemens Friedrich ^[1]; Christiansen, Hans ^[1]

---

1. Department of Radiotherapy and Radiooncology, Universitaetsmedizin Goettingen (Germany)
2. Department of Medical Statistics, Universitaetsmedizin Goettingen (Germany)
3. Department of Surgery, Universitaetsmedizin Goettingen (Germany)

Purpose: To test for a possible correlation between high-grade acute organ toxicity during primary radiochemotherapy and treatment outcome for patients with anal carcinoma. Methods and Materials: From 1991 to 2009, 72 patients with anal carcinoma were treated at our department (10 patients had stage I, 28 patients had stage II, 11 patients had stage IIIA, and 13 patients had stage IIIB cancer [Union Internationale Contre le Cancer criteria]). All patients received normofractionated (1.8 Gy/day, five times/week) whole-pelvis irradiation including iliac and inguinal lymph nodes with a cumulative dose of 50.4 Gy. Concomitant chemotherapy regimen consisted of two cycles of 5-fluorouracil (1,000 mg/m{sup 2}total body surface area (TBSA)/day as continuous intravenous infusion on days 1-4 and 29-32) and mitomycin C (10 mg/m{sup 2}/TBSA, intravenously on days 1 and 29). Toxicity during treatment was monitored weekly, and any incidence of Common Toxicity Criteria (CTC) grade of {>=}3 for skin reaction, cystitis, proctitis, or enteritis was assessed as high-grade acute organ toxicity for later analysis. Results: We found significant correlation between high-grade acute organ toxicity and overall survival, locoregional control, and stoma-free survival, which was independent in multivariate analysis from other possible prognostic factors: patients with a CTC acute organ toxicity grade of {>=}3 had a 5-year overall survival rate of 97% compared to 30% in patients without (p < 0.01, multivariate analysis; 97% vs. 48%, p = 0.03 for locoregional control, and 95% vs. 59%, p = 0.05 for stoma-free survival). Conclusions: Our data indicate that normal tissue and tumor tissue may behave similarly with respect to treatment response, since high-grade acute organ toxicity during radiochemotherapy showed itself to be an independent prognostic marker in our patient population. This hypothesis should be further analyzed by using biomolecular and clinical levels in future clinical trials.

• OSTI ID: 21491687
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 79, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2010.01.010; PII: S0360-3016(10)00034-9; 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
ENTERITIS
LYMPH NODES
MITOMYCIN
PELVIS
PROCTITIS
RECTUM
SKIN
TOXICITY
URACILS
ANTIBIOTICS
ANTI-INFECTIVE AGENTS
ANTIMITOTIC DRUGS
ANTINEOPLASTIC DRUGS
AZINES
BODY
DIGESTIVE SYSTEM
DIGESTIVE SYSTEM DISEASES
DISEASES
DRUGS
GASTROINTESTINAL TRACT
HETEROCYCLIC COMPOUNDS
HYDROXY COMPOUNDS
INTESTINES
LARGE INTESTINE
LYMPHATIC SYSTEM
MEDICINE
NEOPLASMS
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PYRIMIDINES
THERAPY