OC-0364: Brachytherapy in the treatment of anal canal cancers: a large monocentric retrospective series

Modern intensity-modulated radiotherapy with image guidance allows low toxicity rates and good local control in chemoradiotherapy for anal cancer patients

“…The overall rate of non-hematological grade 3-4 acute and late toxicity reported in the RCTs and in large retrospectives series were 54-74, and 11-36%, respectively (Bartelink et al 1997;UKCCCR Anal Cancer Trial Working Party 1996;Flam et al 1996;Lestrade et al 2014;Glynne-Jones et al 2014). Noteworthy, in all these RCTs, radiotherapy was delivered with 2D-or, at the best, 3D-EBRT techniques.…”

“…Intensity-modulated radiation therapy (IMRT) preferentially targets treatment volumes, while minimizing doses to adjacent normal critical structures. Compared to 3D-EBRT, the potential of IMRT in improving the therapeutic ratio of the treatments has been already shown in several diseases (Gomez-Millan et al 2013;De Bari et al 2014;Bauman et al 2012). More evolved forms of IMRT, such as volumetric modulated arc radiotherapy (VMAT) or helical tomotherapy (HT), have been recently introduced also in the treatment of anal cancer.…”

Efficacy and safety of helical tomotherapy with daily image guidance in anal canal cancer patients

“…Optimal dose levels and schedules of EBRT are still under investigation [1] but doses ranging between 45 and 59 Gy showed to be curative, with higher doses needed in poor responders patients [1][2][3][4]. However, international recommendations support the delivery of a boost after the first course of EBRT with or without computed tomography (CT) delivered to the pelvic nodes and to the primary tumor [1], which could be delivered using EBRT or brachytherapy (BRT) [1, 2,5,6]. Published RCT showed an overall rate of non-hematological grade 3-4 acute toxicity of 54-74%, and an overall rate of nonhematological grade 3-4 late toxicity of 11-36% [1,2].…”

Early-stage Favourable Anal Cancer: A Retrospective Analysis of Clinical Outcomes of a Moderately Low Dose Elective Nodal Intensity-modulated Radiotherapy Schedule

“…Despite the liberal selection criteria used in the CORS-03 study to carry out brachytherapy implants (only 26% of the patients presented a T1-2 disease), higher precision and conformality of brachytherapy techniques as well as the possibility for dose escalation have been advocated to explain this difference. Nonetheless, long-term severe sideeffects affecting sphincter function and quality of life have been reported using a brachytherapy boost technique [19,20]. In our series, all analysed patients were also potential candidates for a brachytherapy implant (tumours 3 cm in size, not-fixed, with less than threequarters of anal circumference involvement).…”