Carcinoma of the anal canal

Marshall, David T.; Thomas, Charles R.

doi:10.1007/s12156-009-0006-7

Cited by 3 publications

(4 citation statements)

References 69 publications

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“…Three (4%) patients experienced post-treatment anal stenosis, two (2%) developed chronic non-healing ulcer at the anal verge, 9 (11%) patients had grade 3 incontinence of anal sphincter and in one patient without disease recurrence, colostomy was performed due to the severe anal sphincter dysfunction. The rate of our late side effects is similar to other reports 3,11,22,32,33…”

Section: Discussionsupporting

confidence: 91%

“…In our study, the profile and frequency of acute and late treatment-related toxic side effects were comparable to reports of other researchers 2,10,32. The most frequently reported acute side effect was radiodermatitis with grade 3 or 4 occurring in 58% of patients during EBRT, whereas 15 (18%) patients experienced grade 3 or 4 late radiation side effects.…”

Section: Discussionsupporting

confidence: 89%

“…In our study, the profile and frequency of acute and late treatment-related toxic side effects were comparable to reports of other researchers. 2 , 10 , 32 The most frequently reported acute side effect was radiodermatitis with grade 3 or 4 occurring in 58% of patients during EBRT, whereas 15 (18%) patients experienced grade 3 or 4 late radiation side effects. Three (4%) patients experienced post-treatment anal stenosis, two (2%) developed chronic non-healing ulcer at the anal verge, 9 (11%) patients had grade 3 incontinence of anal sphincter and in one patient without disease recurrence, colostomy was performed due to the severe anal sphincter dysfunction.…”

Section: Discussionmentioning

confidence: 99%

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Long term outcome after combined modality treatment for anal cancer

Oblak¹,

Petric²,

Anderluh³

et al. 2012

Radiology and Oncology

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BackgroundThe aim of the retrospective study was to evaluate the effectiveness and toxicity of radiochemotherapy in patients with squamous cell carcinoma of the anal canal treated at a single institution.Patients and methodsBetween 1/2003 and 9/2010, 84 patients were treated with radical radiochemotherapy at the Institute of Oncology Ljubljana, Slovenia. The treatment consisted of 3-dimensional conformal external beam radiotherapy with concurrent chemotherapy (5-fluorouracil and mytomycin C), followed by brachytherapy or external beam boost. The toxicity of therapy and its effectiveness were assessed.ResultsThe treatment was completed according to the protocol in 79.8% of patients. The median follow-up time of 55 survivors was 53 months (range: 16–105 months). The 5-year locoregional control (LRC), disease-free survival (DFS), disease-specific survival (DSS), overall survival (OS) and colostomy-free survival (CFS) rates were 71%, 68%, 81%, 67% and 85%, respectively. No treatment-related mortality was observed. The most frequent acute side-effect of the treatment was radiodermatitis (grade 3–4 in 58.2% of patients). LENT-SOMA grade 3–4 late radiation side effects were observed in 15 (18%) patients. In patients with brachytherapy boost a trend of less late side effects was observed compared to patients with external beam boost (P=0.066). On multivariate analysis, complete clinical disease response was identified as an independent prognostic factor for LRC, DFS and DSS, the salvage surgery for LRC and DFS, whereas Hb below 120 g/l retained its independent prognostic value for OS.ConclusionsRadiochemotherapy provides an excellent disease control and the survival with preserving anal sphincter function in majority of patients. Surgical salvage with abdominoperineal resection for persistent or recurrent disease has curative potential.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Long term outcome after combined modality treatment for anal cancer

Oblak¹,

Petric²,

Anderluh³

et al. 2012

Radiology and Oncology

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“…The primary goal of the treatment of localized anal cancer is locoregional control with the preservation of organ function. Prior to the 1980s, the primary management of localized anal cancer was surgical resection, involving abdominoperineal resection (APR) requiring permanent colostomy [ 11 ]. Large surgical series demonstrated 5-year overall survival after APR ranging from 40–70% [ 12 , 13 , 14 , 15 , 16 ].…”

Section: Introduction: Surgery Prior To the Introduction Of Chemormentioning

confidence: 99%

Evolution of the Role of Radiotherapy for Anal Cancer

Dee

Byrne

2021

Cancers

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Prior to the 1980s, the primary management of localized anal cancer was surgical resection. Dr. Norman Nigro and colleagues introduced neoadjuvant chemoradiotherapy prior to abdominoperineal resection. Chemoradiotherapy 5-fluorouracil and mitomycin C afforded patients complete pathologic response and obviated the need for upfront surgery. More recent studies have attempted to alter or exclude chemotherapy used in the Nigro regimen to mitigate toxicity, often with worse outcomes. Reductions in acute adverse effects have been associated with marked advancements in radiotherapy delivery using intensity-modulated radiation therapy (IMRT) and image-guidance radiation delivery, resulting in increased tolerance to greater radiation doses. Ongoing trials are attempting to improve IMRT-based treatment of locally advanced disease with efforts to increase personalized treatment. Studies are also examining the role of newer treatment modalities such as proton therapy in treating anal cancer. Here we review the evolution of radiotherapy for anal cancer and describe recent advances. We also elaborate on radiotherapy’s role in locally persistent or recurrent anal cancer.

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The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin

Oblak

Češnjevar

Anzic

et al. 2016

Radiology and Oncology

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BackgroundRadiochemotherapy is the main treatment for patients with squamous cell carcinoma of the anal canal. Anaemia is reported to have adverse effect on survival in cancer patients. The aim of the study was to evaluate the influence of anaemia on radiochemotherapy treatment outcome in patients with squamous cell carcinoma of the anal canal.Patients and methodsOne hundred consecutive patients with histologically confirmed squamous cell carcinoma of the anal canal were treated radically with 3-dimensional conformal or intensity-modulated radiation therapy followed by brachytherapy or external beam radiotherapy boost and with concurrent mitomycin C and 5-fluorouracil. The influence on survival of pre-treatment, mean on-treatment and end-of-treatment haemoglobin (Hb) concentrations was studied.ResultsThe 5-year locoregional control, disease free survival, disease specific survival and overall survival rates for all patients were 72%, 71%, 77% and 62%, respectively. In univariate analysis, patients with pre-treatment and end-of-treatment Hb > 120 g/L survived statistically significantly better compared to patients with Hb ≤ 120 g/L. Patients with mean on-treatment Hb > 120 g/L only had statistically significant better locoregional control and overall survival than patients with Hb ≤ 120 g/L. In multivariate analysis, independent prognostic factors were pre-treatment Hb (> 120 g/L vs. ≤ 120 g/L) for overall survival (hazard ratio [HR] = 0.419, 95% confidence interval [CI] = 0.190–0.927, p = 0.032) and stage (I & II vs. III) for disease specific (HR = 3.523, 95% CI = 1.375–9.026, p = 0.009) and overall survival (HR = 2.230, 95% CI = 1.167–4.264, p = 0.015).ConclusionsThe pre-treatment, mean on-treatment and end-of-treatment Hb concentration > 120 g/L carried better prognosis for patients for with squamous cell carcinoma of the anal canal treated with radiochemotherapy. The pre-treatment Hb > 120 g/L was an independent prognostic factor for overall survival of patients with anal canal cancer.

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Carcinoma of the anal canal

Cited by 3 publications

References 69 publications

Long term outcome after combined modality treatment for anal cancer

Long term outcome after combined modality treatment for anal cancer

Evolution of the Role of Radiotherapy for Anal Cancer

The impact of anaemia on treatment outcome in patients with squamous cell carcinoma of anal canal and anal margin

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