Intensity-modulated Radiation Therapy for Anal Cancer: Results From a Multi-Institutional Retrospective Cohort Study. (February 2016)

• Record Type: Journal Article
• Authors: Call, Jason A.; Prendergast, Brendan M.; Jensen, Lindsay G.; Ord, Celine B.; Goodman, Karyn A.; Jacob, Rojymon; Mell, Loren K.; Thomas, Charles R.; Jabbour, Salma K.; Miller, Robert C.
• Is Part Of: American journal of clinical oncology. Volume 39:Number 1(2016)
• Publication Date: 2016-02
• Subjects: anal cancer -- chemoradiotherapy -- chemotherapy -- combined modality -- intensity-modulated radiation therapy -- squamous cell carcinoma; Cancer -- Treatment -- Periodicals; Oncology -- Periodicals; Tumors -- Periodicals; 616.994005
• DOI: 10.1097/COC.0000000000000009
• Languages: English
• ISSNs: 0277-3732

Abstract

Abstract : Objectives: To assess toxicity and efficacy of intensity-modulated radiation therapy (IMRT) for anal cancer. Methods: Records of 152 patients were reviewed retrospectively from multiple institutions. Data on disease control and toxicity were collected as well as patient and treatment characteristics. Acute (<6 mo) and late (≥6 mo) severe toxicity (grade ≥3) were graded. Four patients were excluded due to the presence of metastatic disease or stage TX. Late toxicity data were available for 120 patients. Results: Median cumulative IMRT dose was 51.25 Gy (median, 28 fractions). All but 2 patients received chemotherapy. With median follow-up of 26.8 months, local control at 3 years was 87%, worse for patients with T3-T4 than T1-T2 disease on univariate analysis (79% vs. 90%; P =0.04). Regional control, distant control, and overall survival were 97%, 91%, and 87%, respectively, at 3 years. Nodal status was associated with regional control, distant control, and overall survival ( P <0.01 for each). Most common severe acute toxicity was hematologic (41%), skin (20%), and gastrointestinal tract (11%). Two grade 5 toxicities occurred (hematologic and gastrointestinal tract). Severe late toxicity affected skin (1%) and gastrointestinal tract (3%). Conclusions: IMRT with chemotherapy resulted in excellent local control. Although T stage predicted worse local control, most T3-T4 disease was controlled with IMRT. Nodal status predicted regional and distant control and overall survival. Severe toxicity was acceptable.