Author/Editor     Grabenbauer, Gerhard G; Panzer, M; Hueltenschmidt, B; Doeker, R; Huber, K; Kuhne-Velte, H J; Hutter, M; Ruehl, U; Budach, V; Wendt, T G; et al, ;
Title     Combined radiation and chemotherapy for squamous cell carcinoma of the anal canal: results and prognostic variables in a multiinstitutional series of 173 patients
Type     članek
Source     Radiol Oncol
Vol. and No.     Letnik 31, št. 2
Publication year     1997
Volume     str. 219-26
Language     eng
Abstract     Purpose: This retrospective multicenter study was aimed to asses the effect of combined modality therapy in patients with squamous cell carcinoma of the anal canal, stage T1-4 NO-3 MO. Patients and methods: Between 1985 and 1994, 173 patients underwent treatment by combined radiation and chemotherapy. A median total dose of 50 Gy was delivered to the primary, perirectal, presacral and inguinal nodes, followed by a local boost in selected cases. 5-Fluorouracil was scheduled as a continuous infusion of 1000 mg/m2/24 h on days 1-5 and 29-33, and mitomycin C as bolus of 10 mg/m2 on days 1 and 29. Results: Cancer related survival (OS), NED-survival and local control rates at 5 years were 71+-5%, 59+-4% and 67+-4%, respictively. Anorectal function was preserved in 91% of the patients in whom the primary was controlled. Only 9.6% experienced severe late toxicity requiring surgery. In univariate analysis, T category (T1/2 vs. T3/4) was predictive for OS (83+-4% vs. 53+-9%, p=0.01), NED-surival (75+-4% vs. 36+-7%, p<0.0001) and local control (81+-4% vs. 46+-7%, p<0.0001). N category (NO vs. N1-3) influenced NED-servival (66+-5% vs. 33+-12%, p=0.004) and local control (76+-4% vs. 37+-13%, p=0.003). Treatment technique (<2 fields vs. 2 fields) was found to be of prognostic value for NED-surival (70+-6%, sv. 50+-6%, p=0.016) and local control (77+-6% vs.58+-6%, p=0.018). Only in T3/4 cases the total RT-dose (<45 Gy vs. 45 Gy) had an impact on NED-survival (42+-7% vs. 23+-13%, p=0.01) and local control (52+-8% vs. 45+-15%, p=0.03). In multivariate analysis, the T category (UICC 1922) remained the only significant variable with impact on survival (p=0.04), NED-survival (p<0.001) and local control (p=0.003). Conclusion: Treatment with a combination of radiotherapy and chemotherapy is safe and effective for patients with anal canal carcinoma. The improvement of results in advanced stages is warranted.
Descriptors     RECTAL NEOPLASMS
CARCINOMA, SQUAMOUS CELL
FLUOROURACIL
MITOMYCIN C
TREATMENT OUTCOME
SURVIVAL ANALYSIS
NEOPLASM STAGING
MULTICENTER STUDIES