Induction Chemotherapy and Dose Intensification of the Radiation Boost in Locally Advanced Anal Canal Carcinoma: Final Analysis of the Randomized UNICANCER ACCORD 03 Trial

Peiffert, D.; Tournier-Rangeard, L.; Gérard, Jean-Pierre; Lemanski, C.; François, Ετιεννε; Giovannini, Marc; Cvitkovic, F.; Mirabel, X.; Bouché, Olivier; Luporsi, É.; Conroy, Thierry; Montoto-Grillot, C.; Mornex, F.; Lusinchi, A.; Hannoun‐Lévi, Jean‐Michel; Seitz, Jean‐François; Adenis, Antoine; Hennequin, Christophe; Denis, Bernard; Ducreux, Michel

doi:10.1200/jco.2011.35.4837

Cited by 307 publications

(206 citation statements)

References 29 publications

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“…Our results suggest that the 3-step approach may not provide additional benefit to CCRT in patients with locally advanced esophageal squamous cell carcinoma. This is also in line with data from anal cancer, which showed that induction chemotherapy may worsen local tumor control compared with chemoradiotherapy alone (23). Although the systemic failure rate was numerically lower in the induction chemotherapy group (19.1% vs 34.0%), this did not translate into a survival benefit.…”

Section: Discussionsupporting

confidence: 89%

Randomized Phase 2 Trial of S1 and Oxaliplatin-Based Chemoradiotherapy With or Without Induction Chemotherapy for Esophageal Cancer

Yoon

Jang

Kim

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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Section: Discussionsupporting

confidence: 89%

Randomized Phase 2 Trial of S1 and Oxaliplatin-Based Chemoradiotherapy With or Without Induction Chemotherapy for Esophageal Cancer

Yoon

Jang

Kim

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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“…This report on the use of SIB-IMRT with capecitabine and MMC for anal carcinoma shows that the efficacy is similar as in recent larger series using conventional radiation techniques [18][19][20]. This is also in accordance with a recently published smaller retrospective series, using SIB-IMRT with 5-FU instead of capecitabine [21].…”

Section: Discussionsupporting

confidence: 79%

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

et al. 2016

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Background and purpose To retrospectively evaluate locoregional control (LRC), survival and toxicity in anal cancer patients treated with simultaneous integrated boost -intensity modulated radiation therapy (SIB-IMRT) ± concurrent chemotherapy. Methods and materials Patients with squamous cell anal carcinoma stage T1(!1 cm)-4, N0-3, M0-1 were included. All patients were treated with SIB-IMRT to a total dose of 59.4 Gy delivered to the primary tumor and macroscopically involved lymph nodes and 49.5 Gy to elective lymph node areas. If macroscopic residual tumor was still present in the fifth week of irradiation, a sequential boost of 5.4 Gy was given. Concurrent chemotherapy was administered in locally advanced cases. Acute and late toxicity were scored. Results One hundred and six patients treated consecutively between April 2006 and December 2012 were included. Eighty-seven (82.1%) patients received concurrent chemotherapy. The median follow-up was 47 months (range 2-104 months). Ninety-eight patients reached a clinical complete response (92.5%). Four-year actuarial LRC rate, overall survival and colostomy-free survival were 79%, 77% and 77%, respectively. Acute grade !3 toxicity occurred in 67.9% of the patients. Late grade 3 toxicity was seen in 16 patients (15.1%). Conclusions SIB-IMRT ± concurrent chemotherapy for anal cancer was effective with acceptable toxicity.

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“…Subsequent trials [4][5][6] showcased the superiority of this treatment regimen over radiotherapy alone or radiotherapy with only 5-FU using different endpoints such as local control, recurrence free survival, progression free survival, colostomy free survival or overall survival and thus radiotherapy with MMC and 5FU became the standard of care. Follow-up phase III trials failed to demonstrate benefits of alternative treatments schedules such as replacing MMC with cisplatin [7][8][9]. 5 year disease-free survival rates are reported as approximately 65% [8].…”

Section: Introduction Backgroundmentioning

confidence: 99%

Systematic review of the quality of life issues associated with anal cancer and its treatment with radiochemotherapy

Sodergren

Vassiliou

Dennis

et al. 2015

Support Care Cancer

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PurposeRadiochemotherapy is the standard of care for the treatment of anal carcinoma achieving good loco-regional control and sphincter preservation. This approach is however associated with acute and late toxicities including haematological, skin, bowel function and genito-urinary complications. This paper systematically reviews studies addressing the quality of life (QoL) implications of anal cancer and radiochemotherapy. The paper also evaluates how QoL is assessed in anal cancer. MethodsMedline, EMBASE, CINAHL, PsycInfo, Web of Science and the Cochrane Library were searched for publications (1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014) reporting the effects on patients of anal cancer and radiochemotherapy. ResultsOf the 152 papers reporting treatment-related effects on patients, only 11 provided a formal assessment of QoL. In the absence of an anal cancer specific measure, QoL was assessed using generic cancer instruments such as the core EORTC quality of life questionnaire (EORTC QLQ-C30) or colorectal cancer tools such as the EORTC QLQ-CR29. Bowel function, particularly diarrhoea, and sexual problems were the most commonly reported QoL concerns. The review of QoL issues of anal cancer patients treated with radiochemotherapy is limited by the QoL assessment measures used. It is argued that certain treatment-related toxicities, for example skin-induced radiation problems are overlooked or inadequately represented in existing measures. ConclusionsThis review emphasises the need to develop an anal cancer specific QoL measure and to incorporate QoL as an outcome of future trials in anal cancer. The results of this review are informative to clinicians and patients in terms of treatment decision making.

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Induction Chemotherapy and Dose Intensification of the Radiation Boost in Locally Advanced Anal Canal Carcinoma: Final Analysis of the Randomized UNICANCER ACCORD 03 Trial

Abstract: Using CFS as our main end point, we did not find an advantage for either ICT or HD radiation boost in LAACC. Nevertheless, the results of the most treatment-intense arm B should prompt the design of further intensification studies.

Cited by 307 publications

References 29 publications

Randomized Phase 2 Trial of S1 and Oxaliplatin-Based Chemoradiotherapy With or Without Induction Chemotherapy for Esophageal Cancer

Randomized Phase 2 Trial of S1 and Oxaliplatin-Based Chemoradiotherapy With or Without Induction Chemotherapy for Esophageal Cancer

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

Systematic review of the quality of life issues associated with anal cancer and its treatment with radiochemotherapy

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