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

Abstract

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%more » 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.« less

Authors:
 [1];  [1]; ; ; ;  [2]; ;  [3]; ;  [4]
  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)
Publication Date:
OSTI Identifier:
21491589
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 79; Journal 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.; Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
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

Citation Formats

Olivatto, Luis O., E-mail: olivatto@inca.gov.b, Cabral, Vania, Rosa, Arthur, Bezerra, Marcos, Santarem, Erick, Fassizoli, Ana, Castro, Leonaldson, Simoes, Jose Humberto, Small, Isabele A., and Ferreira, Carlos Gil. Mitomycin-C- or Cisplatin-Based Chemoradiotherapy for Anal Canal Carcinoma: Long-Term Results. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2009.11.057.
Olivatto, Luis O., E-mail: olivatto@inca.gov.b, Cabral, Vania, Rosa, Arthur, Bezerra, Marcos, Santarem, Erick, Fassizoli, Ana, Castro, Leonaldson, Simoes, Jose Humberto, Small, Isabele A., & Ferreira, Carlos Gil. Mitomycin-C- or Cisplatin-Based Chemoradiotherapy for Anal Canal Carcinoma: Long-Term Results. United States. doi:10.1016/j.ijrobp.2009.11.057.
Olivatto, Luis O., E-mail: olivatto@inca.gov.b, Cabral, Vania, Rosa, Arthur, Bezerra, Marcos, Santarem, Erick, Fassizoli, Ana, Castro, Leonaldson, Simoes, Jose Humberto, Small, Isabele A., and Ferreira, Carlos Gil. Tue . "Mitomycin-C- or Cisplatin-Based Chemoradiotherapy for Anal Canal Carcinoma: Long-Term Results". United States. doi:10.1016/j.ijrobp.2009.11.057.
@article{osti_21491589,
title = {Mitomycin-C- or Cisplatin-Based Chemoradiotherapy for Anal Canal Carcinoma: Long-Term Results},
author = {Olivatto, Luis O., E-mail: olivatto@inca.gov.b and Cabral, Vania and Rosa, Arthur and Bezerra, Marcos and Santarem, Erick and Fassizoli, Ana and Castro, Leonaldson and Simoes, Jose Humberto and Small, Isabele A. and Ferreira, Carlos Gil},
abstractNote = {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.},
doi = {10.1016/j.ijrobp.2009.11.057},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 2,
volume = 79,
place = {United States},
year = {2011},
month = {2}
}