Radiotherapy with or without chemotherapy in the treatment of anal cancer: 20-year experience from a single institute.

摘要: To report the efficacy and toxicity of radio(chemo)therapy (RCT) in management squamous cell anal carcinoma (SQ-AC) to evaluate prognostic factors influencing outcomes. A consecutive cohort 138 patients with cT1-4, cN0-3, cM0 SQ-AC were treated RCT between 1988 2011 at our department. Median follow-up time for surviving from start was 98 months (range, 1–236 months). Patients a median radiation dose 56 Gy 4–61 Gy). Concurrent chemotherapy administered 119 (86%). The survival rates 2, 5, 10 years 88 ± 3, 82 ± 4, 59 ± 6%, respectively, overall (OS) 167 months. cumulative incidence local recurrence 2 5 years 8 ± 2 11 ± 3%, respectively. disease-free (DFS) colostomy-free (CFS) times 132 135 months, In 19 (14%), distant metastasis diagnosed after 19 months. multivariate analysis, UICC (International Union Against Cancer) stage I-II, female gender, Eastern Cooperative Oncology Group (ECOG) performance status 0–1, good/moderate histologic differentiation (G1–2) significantly associated better OS, DFS, CFS. Conformal radiotherapy planning techniques lower (11 ± 3% vs. 38 ± 19% 5 years, p = 0.006). higher beyond 54 Gy not an improvement outcome, neither smaller—(T1/T2) nor larger tumors (T3/T4). leads excellent outcomes—especially I/II G1/G2 tumors—with acceptable toxicity. probable advantages high-dose should be considered carefully against risk rate Future studies are needed investigate role more intensified (systemic) treatment unfavorable such as T3/T4, N+, and/or poor differentiation.