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

Détails

ID Serval
serval:BIB_49A2277749ED
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Modern intensity-modulated radiotherapy with image guidance allows low toxicity rates and good local control in chemoradiotherapy for anal cancer patients.
Périodique
Journal of cancer research and clinical oncology
Auteur(s)
De Bari B., Lestrade L., Franzetti-Pellanda A., Jumeau R., Biggiogero M., Kountouri M., Matzinger O., Miralbell R., Bourhis J., Ozsahin M., Zilli T.
ISSN
1432-1335 (Electronic)
ISSN-L
0171-5216
Statut éditorial
Publié
Date de publication
04/2018
Peer-reviewed
Oui
Volume
144
Numéro
4
Pages
781-789
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
To report outcomes of a population of anal cancer patients treated with modern intensity-modulated radiotherapy and daily image-guided radiotherapy techniques.
We analyzed data of 155 patients consecutively treated with intensity-modulated radiotherapy +/- chemotherapy in three radiotherapy departments. One hundred twenty-two patients presented a stage II-IIIA disease. Chemotherapy was administered in 138 patients, mainly using mitomycin C and 5-fluorouracil (n = 81). All patients received 36 Gy (1.8 Gy/fraction) on the pelvic and inguinal nodes, on the rectum, on the mesorectum and on the anal canal, and a sequential boost up to a total dose of 59.4 Gy (1.8 Gy/fraction) on the anal canal and on the nodal gross tumor volumes.
Median follow-up was 38 months (interquartile range 12-51). Toxicity data were available for 143 patients: 22% of them presented a G3+ acute toxicity, mainly as moist desquamation (n = 25 patients) or diarrhea (n = 10). Three patients presented a late grade 3 gastrointestinal toxicity (anal incontinence). No grade 4 acute or late toxicity was recorded. Patients treated with fixed-gantry IMRT delivered with a sliding window technique presented a significantly higher risk of acute grade 3 (or more) toxicity compared to those treated with VMAT or helical tomotherapy (38.5 vs 15.3%, p = 0.049). Actuarial 4-year local control rate was 82% (95% CI 76-91%).
Modern intensity-modulated radiotherapy with daily image-guided radiotherapy is effective and safe in treating anal cancer patients and should be considered the standard of care in this clinical setting.

Mots-clé
Aged, Anus Neoplasms/diagnostic imaging, Anus Neoplasms/drug therapy, Anus Neoplasms/radiotherapy, Chemoradiotherapy, Female, Humans, Male, Middle Aged, Radiotherapy, Intensity-Modulated/adverse effects, Radiotherapy, Intensity-Modulated/methods, Randomized Controlled Trials as Topic, Anal cancer, Helical tomotherapy, IMRT, Local control, Toxicity, VMAT
Pubmed
Web of science
Création de la notice
15/02/2018 17:31
Dernière modification de la notice
20/08/2019 13:57
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