Radiation therapy in the conservative treatment of carcinoma of the anal canal

Wagner, Jean-Philippe; Mahé, M.-A.; Romestaing, P.; Rocher, François; Berger, C.; Trillet‐Lenoir, Véronique; Gérard, Jean-Pierre

doi:10.1016/0360-3016(94)90221-6

Cited by 70 publications

(27 citation statements)

References 13 publications

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“…Impairment of anal function depends, in large measure, on the extent of prior surgical intervention or on subsequent biopsy, and this can become a permanent problem. Interstitial brachytherapy is associated with a higher incidence of anal dysfunction as a result of tissue necrosis; this ranges from 2%-15% [41][42][43][44][45].…”

Section: Treatment-related Toxicitiesmentioning

confidence: 99%

Carcinoma of the Anus: Strategies in Management

2002

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The management of anal cancer underwent an interesting transformation over the last two decades. Prior to this period, the standard definitive treatment for carcinoma of the anal canal was abdominal-perineal resection, which necessitated a permanent colostomy. The organ preservation concept appeared following the discovery of a high complete response rate from preoperative combined chemoradiation prior to abdominal-perineal resection.The organ preservation method of treatment rapidly gained popularity and ultimately saved a large number of patients from undergoing abdominal-perineal resection and colostomy. Chemoradiation treatment itself subsequently went through an evolutionary process. Several studies have sought to define the optimal chemotherapeutic regimen as well as radiation treatment dose and fractionation. Ongoing studies attempt to define an optimal treatment regimen that yields a higher cure rate while minimizing toxicity. We review the etiology, epidemiology, and treatment regimens for anal cancer.

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Section: Treatment-related Toxicitiesmentioning

confidence: 99%

Carcinoma of the Anus: Strategies in Management

2002

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“…[Key words: Anal carcinoma; Anal margin; Radiochemotherapy] prospective randomized trials, mainly because longterm results after radiation alone were available from different centers. [1][2][3][4][5][6][7] In the early 1970s, Papillon and colleagues 3,4 reported on the use of cobalt 60 (Co-60) sources with remarkable treatment techniques and fractionation schedules for anal canal carcinoma. Tumor control and sphincter preservation rates have been as high as 80 percent and 66 percent, respectively, with Grade 3 proctitis being in the range of 10 to 15 percent.…”

mentioning

confidence: 99%

Tumor Site Predicts Outcome After Radiochemotherapy in Squamous-Cell Carcinoma of the Anal Region: Long-Term Results of 101 Patients

Grabenbauer

Keßler

Matzel

et al. 2005

Diseases of the Colon &Amp; Rectum

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“…As regards risk factors, Peiffert et al [13] compared the value of different prognostic factors from 9 studies, reporting only T stage consistently as a prognostic factor in 8 of 9 studies, whereas the influence of other factors such as N category, sex, and age was inconsistent [14][15][16][17][18][19][20]. In our evaluation, T stage was a strong factor predicting CFS and showed a tendency for DSS.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcome after Combined Radiochemotherapy for Anal Cancer – Retrospective Analysis of Efficacy, Prognostic Factors, and Toxicity

Sabine

Welzel²,

Hermann³

et al. 2008

Onkologie

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Background: This retrospective study evaluated the efficacy, prognostic factors, and toxicity of combined radiochemotherapy for anal cancer. Patients and Methods: Data of 90 patients treated with radiochemotherapy between 1990 and 2006 were analyzed. Mean follow-up was 30 months (range: 2–129 months). Endpoints were disease-specific survival, local control, freedom from metastasis, and colostomy-free survival. Tumor stage, nodal status, age, sex, tumor site, tumor resection, and radiation dose were analyzed for prognostic value. Acute toxicity was scored according to the RTOG/EORTC scale, late toxicity according to the LENT/ SOMA scale. Results: Disease-specific survival was 86%, local control 79%, freedom from metastasis 92%, and colostomy-free survival 83%. Higher T category was associated with inferior prognosis for colostomy-free survival (p = 0.000), male sex for local control (p = 0.004) and diseasespecific survival (p = 0.002), and tumor site at the anal margin for local control (p = 0.03). 4 of 7 patients with recurrent anal margin tumors had human papillomavirus (HPV)-related disease. 49% of patients suffered from ≧ grade 3 acute toxicity. 3 patients had late toxicity of grade 3 concerning sphincter control. Conclusion: Combined radiochemotherapy for anal cancer is a highly effective therapy with pronounced acute and minor late toxicity. In the case of higher T stage, male sex, and cancer at the anal margin, treatment intensification should be considered.

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Radiation therapy in the conservative treatment of carcinoma of the anal canal

Cited by 70 publications

References 13 publications

Carcinoma of the Anus: Strategies in Management

Carcinoma of the Anus: Strategies in Management

Tumor Site Predicts Outcome After Radiochemotherapy in Squamous-Cell Carcinoma of the Anal Region: Long-Term Results of 101 Patients

Long-Term Outcome after Combined Radiochemotherapy for Anal Cancer – Retrospective Analysis of Efficacy, Prognostic Factors, and Toxicity

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Radiation therapy in the conservative treatment of carcinoma of the anal canal

Cited by 70 publications

References 13 publications

Carcinoma of the Anus: Strategies in Management

Carcinoma of the Anus: Strategies in Management

Tumor Site Predicts Outcome After Radiochemotherapy in Squamous-Cell Carcinoma of the Anal Region: Long-Term Results of 101 Patients

Long-Term Outcome after Combined Radiochemotherapy for Anal Cancer &ndash; Retrospective Analysis of Efficacy, Prognostic Factors, and Toxicity

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Long-Term Outcome after Combined Radiochemotherapy for Anal Cancer – Retrospective Analysis of Efficacy, Prognostic Factors, and Toxicity