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Title: Chemoradiotherapy of Anal Carcinoma: Survival and Recurrence in an Unselected National Cohort

Abstract

Purpose: To evaluate treatment results, elucidate whether national guidelines were followed, and identify areas demanding further treatment optimization. Methods and Material: Between July 2000 and June 2007, 328 patients were treated with curatively intended chemoradiotherapy (CRT) for nonmetastatic squamous cell carcinoma of the anal region, according to national treatment guidelines based on tumor stage. Results: Complete response after CRT was obtained in 87% of patients, rising to 93% after salvage surgery. Chemotherapy, elective irradiation of the groin and salvage surgery were performed to a lesser extent in elderly patients, mainly because of frailty and comorbidity. Recurrence occurred in 24% of the patients, resulting in a 3- and 5-year recurrence-free survival (RFS) of 79% and 74%, respectively. Locoregional recurrences dominated, most commonly in the primary tumor site. Recurrence was treated with curative intent in 45% of the cases. The 3- and 5-year overall survival were 79% and 66%, and cancer-specific survival (CSS) were 84% and 75%, respectively. The risk of adverse outcome increased significantly with more locally advanced tumors and for male gender in multivariable analyses for RFS and CSS. Conclusions: The treatment results are in accordance with similar cohorts. The primary treatment control rate was high, but there was amore » significant risk of locoregional recurrence in advanced tumors. The loyalty to national guidelines was broad, although individual adjustments occurred. However, caution to avoid toxicity must not lead to inadequate treatment. Male gender seems to have inferior outcome.« less

Authors:
 [1];  [2]; ;  [3];  [4];  [3];  [2];  [5];  [6];  [1];  [2]
  1. Department of Oncology, University Hospital of Northern Norway, Tromso (Norway)
  2. (Norway)
  3. Department of Oncology, Oslo University Hospital, Oslo (Norway)
  4. Department of Oncology, St. Olav's University Hospital, Trondheim, Norway and The Norwegian Radiation Protection Authority (NRPA), Osteras (Norway)
  5. Department of Community Medicine, University of Tromso, Tromso (Norway)
  6. Section of Oncology, Institute of Medicine, University of Bergen and Department of Oncology, Haukeland University Hospital, Bergen (Norway)
Publication Date:
OSTI Identifier:
22056392
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 83; Journal Issue: 2; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; CHEMOTHERAPY; COMBINED THERAPY; FAILURES; HAZARDS; IRRADIATION; OPTIMIZATION; PATIENTS; RECOMMENDATIONS; SURGERY; TOXICITY

Citation Formats

Bentzen, Anne Gry, E-mail: anne.gry.bentzen@unn.no, Institute of Clinical Medicine, University of Tromso, Tromso, Guren, Marianne G., Wanderas, Eva H., Frykholm, Gunilla, Tveit, Kjell M., Faculty of Medicine, University of Oslo, Oslo, Wilsgaard, Tom, Dahl, Olav, Balteskard, Lise, and Centre for Clinical Documentation and Evaluation, Northern Norway Regional Health Authority, Tromso. Chemoradiotherapy of Anal Carcinoma: Survival and Recurrence in an Unselected National Cohort. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.12.062.
Bentzen, Anne Gry, E-mail: anne.gry.bentzen@unn.no, Institute of Clinical Medicine, University of Tromso, Tromso, Guren, Marianne G., Wanderas, Eva H., Frykholm, Gunilla, Tveit, Kjell M., Faculty of Medicine, University of Oslo, Oslo, Wilsgaard, Tom, Dahl, Olav, Balteskard, Lise, & Centre for Clinical Documentation and Evaluation, Northern Norway Regional Health Authority, Tromso. Chemoradiotherapy of Anal Carcinoma: Survival and Recurrence in an Unselected National Cohort. United States. doi:10.1016/J.IJROBP.2011.12.062.
Bentzen, Anne Gry, E-mail: anne.gry.bentzen@unn.no, Institute of Clinical Medicine, University of Tromso, Tromso, Guren, Marianne G., Wanderas, Eva H., Frykholm, Gunilla, Tveit, Kjell M., Faculty of Medicine, University of Oslo, Oslo, Wilsgaard, Tom, Dahl, Olav, Balteskard, Lise, and Centre for Clinical Documentation and Evaluation, Northern Norway Regional Health Authority, Tromso. Fri . "Chemoradiotherapy of Anal Carcinoma: Survival and Recurrence in an Unselected National Cohort". United States. doi:10.1016/J.IJROBP.2011.12.062.
@article{osti_22056392,
title = {Chemoradiotherapy of Anal Carcinoma: Survival and Recurrence in an Unselected National Cohort},
author = {Bentzen, Anne Gry, E-mail: anne.gry.bentzen@unn.no and Institute of Clinical Medicine, University of Tromso, Tromso and Guren, Marianne G. and Wanderas, Eva H. and Frykholm, Gunilla and Tveit, Kjell M. and Faculty of Medicine, University of Oslo, Oslo and Wilsgaard, Tom and Dahl, Olav and Balteskard, Lise and Centre for Clinical Documentation and Evaluation, Northern Norway Regional Health Authority, Tromso},
abstractNote = {Purpose: To evaluate treatment results, elucidate whether national guidelines were followed, and identify areas demanding further treatment optimization. Methods and Material: Between July 2000 and June 2007, 328 patients were treated with curatively intended chemoradiotherapy (CRT) for nonmetastatic squamous cell carcinoma of the anal region, according to national treatment guidelines based on tumor stage. Results: Complete response after CRT was obtained in 87% of patients, rising to 93% after salvage surgery. Chemotherapy, elective irradiation of the groin and salvage surgery were performed to a lesser extent in elderly patients, mainly because of frailty and comorbidity. Recurrence occurred in 24% of the patients, resulting in a 3- and 5-year recurrence-free survival (RFS) of 79% and 74%, respectively. Locoregional recurrences dominated, most commonly in the primary tumor site. Recurrence was treated with curative intent in 45% of the cases. The 3- and 5-year overall survival were 79% and 66%, and cancer-specific survival (CSS) were 84% and 75%, respectively. The risk of adverse outcome increased significantly with more locally advanced tumors and for male gender in multivariable analyses for RFS and CSS. Conclusions: The treatment results are in accordance with similar cohorts. The primary treatment control rate was high, but there was a significant risk of locoregional recurrence in advanced tumors. The loyalty to national guidelines was broad, although individual adjustments occurred. However, caution to avoid toxicity must not lead to inadequate treatment. Male gender seems to have inferior outcome.},
doi = {10.1016/J.IJROBP.2011.12.062},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 2,
volume = 83,
place = {United States},
year = {2012},
month = {6}
}