Anal Cancer Treated with Radio-chemotherapy: Correlation between Length of Treatment Interruption and Outcome

Clinical outcome in patients treated with simultaneous integrated boost – intensity modulated radiation therapy (SIB-IMRT) with and without concurrent chemotherapy for squamous cell carcinoma of the anal canal

“…The omission of a treatment gap in our series is probably the most important factor responsible for the better LRC and CCR compared with these two older trials. The negative impact of increased gap duration is well recognized [4][5][6][7][8]. The SIB-IMRT technique used in our series allows an even shorter treatment gap and further reduces the OTT, which has the theoretical advantage of improving local control.…”

“…The former was attributed to, among other factors, the use of a long treatment gap [i.e. a rest period of six weeks between initial CRT and radiotherapy (RT) boost] [4][5][6][7][8], whereas the latter is probably due to the use of two large opposed anterior-posterior fields or a three-field technique [1,2].…”

Postoperative versus definitive chemoradiation in early-stage anal cancer

“…In fact, severe acute toxicity of CRT in anal carcinoma is common leading to frequent treatment interruptions and dose reductions [15]. Serious late and consequential late effects on gastrointestinal and genitourinary function have been reported in up to 25% of patients [18], even though contemporary conformal RT techniques such as IMRT reduce the incidence [24].…”

Anal Cancer: An Examination of Radiotherapy Strategies

“…Yet cervix cancer data suggest loss of local control of 1% per day if OTT is extended beyond 52 days. In anal cancer, a long OTT may reduce local control (59), but short gaps may not be crucial for early tumors (60). When the RTOG 8704 and RTOG 9811 studies were pooled, on univariate analysis there was a significant association between CFS and OTT, suggesting that extending OTT increases colostomy rate (61).…”