Intracavitary Afterloading Boost in Anal Canal Carcinoma Results, Function and Quality of Life

Vordermark, Dirk; Flentje, Michael; Sailer, M.; Kölbl, Oliver

doi:10.1007/pl00002405

Cited by 14 publications

(12 citation statements)

References 14 publications

(30 reference statements)

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“…For LCR, our series reported a rate of 83% with a 27.5 median FU. This result is quite comparable to those presented by the other HDR studies [16-19,15]. We reported a 2-year OS rate of 87.7%.…”

Section: Discussionsupporting

confidence: 92%

Interstitial high-dose rate brachytherapy as boost for anal canal cancer

et al. 2014

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AimTo assess clinical outcomes of patients treated with a high-dose rate brachytherapy boost for anal canal cancer (ACC).MethodsFrom August 2005 to February 2013, 28 patients presenting an ACC treated by split-course external beam radiotherapy (EBRT) and HDR brachytherapy with or without chemotherapy in a French regional cancer center in Nice were retrospectively analyzed.ResultsMedian age was 60.6 years [34 – 83], 25 patients presented a squamous cell carcinoma and 3 an adenocarcinoma; 21 received chemotherapy. Median dose of EBRT was 45 Gy [43.2 – 52]. Median dose of HDR brachytherapy was 12 Gy [10 - 15] with a median duration of 2 days. Median overall treatment time was 63 days and median delay between EBRT and brachytherapy was 20 days. Two-year local relapse free, metastatic free, disease free and overall survivals were 83%, 81.9%, 71.8% and 87.7% respectively. Acute toxicities were frequent but not severe with mostly grade 1 toxicities: 37% of genito-urinary, 40.7% of gastro-intestinal and 3.7% of cutaneous toxicities. Late toxicities were mainly G1 (43.1%) and G2 (22%). Two-year colostomy-free survival was 75.1%, one patient had a definitive sphincter amputation.ConclusionHigh-dose rate brachytherapy for anal canal carcinoma as boost represents a feasible technique compared to low or pulsed-dose rate brachytherapy. This technique remains an excellent approach to precisely boost the tumor in reducing the overall treatment time.

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Section: Discussionsupporting

confidence: 92%

Interstitial high-dose rate brachytherapy as boost for anal canal cancer

et al. 2014

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“…Several reports of anal cancer patients show similar QoL scores to population norms [37,29,40,43,41,34]. Allal et al [37] also identified disparities between objective and subjective parameters in relation to anorectal function and satisfaction.…”

Section: Discussionmentioning

confidence: 83%

“…Six of the studies assessed QoL in the context of known group comparisons, for example according to age, sex, employment and marital status, treatment type and disease parameters [37,38,34,39,36,40,41]. Comparisons were also made using reference values from published normative data from the general population or other disease groups [42,40,43,41,37,38] while two studies included matched healthy volunteers [42,44]. QoL was a primary end point for 9 studies and for 8 of these studies data on longterm QoL issues were provided with intervals between treatment and assessment varying from 2 years [38] to more than 12 years [44,40].…”

Section: Quality Assessment Of Qol Reportingmentioning

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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“…Empiric studies on the extent of psychosocial stress among cancer patients have produced inconsistent results [3,5,13,22,26]. Only a few of these studies are representative of a radiotherapy treatment schedule.…”

Section: Introductionmentioning

confidence: 99%