Role of brachytherapy in the treatment of cancers of the anal canal. Long-term follow-up and multivariate analysis of a large monocentric retrospective series.

Details

Serval ID
serval:BIB_4CC0399FAB1E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Role of brachytherapy in the treatment of cancers of the anal canal. Long-term follow-up and multivariate analysis of a large monocentric retrospective series.
Journal
Strahlentherapie Und Onkologie
Author(s)
Lestrade L., De Bari B., Pommier P., Montbarbon X., Lavergne E., Ardiet J.M., Carrie C.
ISSN
1439-099X (Electronic)
ISSN-L
0179-7158
Publication state
Published
Issued date
2014
Volume
190
Number
6
Pages
546-554
Language
english
Notes
Publication types: Comparative Study ; Journal ArticlePublication Status: ppublish
Abstract
BACKGROUND AND PURPOSE: There are few data on long-term clinical results and tolerance of brachytherapy in anal canal cancer. We present one of the largest retrospective analyses of anal canal cancers treated with external beam radiotherapy with/without (±) chemotherapy followed by a brachytherapy boost.
MATERIALS AND METHODS: We performed a retrospective analysis of clinical results in terms of efficacy and toxicity. The impact of different clinical and therapeutic variables on these outcomes was studied.
RESULTS: From May 1992 to December 2009, 209 patients received brachytherapy after external beam radiotherapy ± chemotherapy. Of these patients, 163 were stage II or stage IIIA (UICC 2002) and 58 were N1-3. According to age, ECOG performance status (PS), and comorbidities, patients received either radiotherapy alone (58/209) or radiochemotherapy (151/209). The median follow-up was 72.8 months. The 5- and 10-year local control rates were 78.6 and 73.9 %, respectively. Globally, severe acute and late G3-4 reactions (NCI-CTC scale v. 4.0) occurred in 11.2 and 6.3 % of patients, respectively. Univariate analysis showed the statistical impact of the pelvic treatment volume (p = 0.046) and of the total dose (p = 0.02) on the risk of severe acute and late toxicities, respectively. Only six patients required permanent colostomy because of severe late anorectal toxicities.
CONCLUSION: After a long follow-up time, brachytherapy showed an acceptable toxicity profile and high local control rates in patients with anal canal cancer.
Keywords
Adult, Aged, Aged, 80 and over, Anus Neoplasms/drug therapy, Anus Neoplasms/mortality, Brachytherapy/methods, Chemoradiotherapy, Colostomy, Combined Modality Therapy, Disease-Free Survival, Female, Follow-Up Studies, Humans, Lymphatic Metastasis/pathology, Lymphatic Metastasis/radiotherapy, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging, Radiation Injuries/etiology, Radiation Injuries/surgery, Retrospective Studies
Pubmed
Web of science
Create date
19/06/2015 16:04
Last modification date
20/08/2019 15:01
Usage data