TY - JOUR
T1 - Radiotherapy for anal cancer
T2 - Experience from 1979-1987
AU - Hughes, Lorie L.
AU - Rich, Tyvin A.
AU - Delclos, Luis
AU - Ajani, Jaffer A.
AU - Martin, Richard G.
N1 - Funding Information:
Acknowledgements-We gratefully acknowledge Marie Byrd, Mary Jane Oswald, and Ann Nette Pearce for their assistance in this study. Financial support: This work was supported in part by grants CA06294 and CA 16672 from the National Cancer Institute, U.S. Department of Health and Human Services. Accepted for publication 17 May 1989.
PY - 1989/12
Y1 - 1989/12
N2 - Seventy patients with squamous cell carcinoma or cloacogenic carcinoma of the anus treated from 1979-1987 were reviewed. Five groups were analyzed: (a) local excision (LE) with postoperative radiotherapy (n = 9); (b) abdomino-perineal resection (APR) with either pre- or postoperative radiotherapy (n = 22); (c) definitive radiotherapy alone (n = 8); (d) radiotherapy with continuous 5-Fluorouracil (5-FU) infusion (chemoradiation) (n = 25); and (e) patients treated for recurrent disease (n = 6). Abdomino-perineal resection and radiotherapy resulted in an actuarial local control (LC) rate of 90% and an overall 5-year survival rate of 77% (median follow-up, 48 months). All patients in Group 1 and 5 8 patients in Group 3 had locally controlled disease and were disease-free. The chemoradiation protocol resulted in a complete clinical response rate of 75% ( 18 24, one patient died during treatment) assessed 4-6 weeks after treatment. The colostomy-free local control rate with chemoradiation is 67% ( 16 24). Local control was 50% for all stages receiving 45-49 Gy and 90% for those patients receiving ?55 Gy but was not correlated with total 5-FU dose. Abdomino-perineal resection was performed to salvage six patients with persistent disease and two with recurrent disease, resulting in an overall local control rate of 92% ( 22 24). The actuarial survival was 96% (median follow-up, 14 months; range, 1-30). The acute complications of radiotherapy included diarrhea and perineal skin reactions that were increased by 5-FU infusion. However, diarrhea can be ameliorated by a modified treatment technique that reduces irradiation to the small intestine. For the entire patient group, minor late complications occurred in 23%, and major complications occurred in 9%.
AB - Seventy patients with squamous cell carcinoma or cloacogenic carcinoma of the anus treated from 1979-1987 were reviewed. Five groups were analyzed: (a) local excision (LE) with postoperative radiotherapy (n = 9); (b) abdomino-perineal resection (APR) with either pre- or postoperative radiotherapy (n = 22); (c) definitive radiotherapy alone (n = 8); (d) radiotherapy with continuous 5-Fluorouracil (5-FU) infusion (chemoradiation) (n = 25); and (e) patients treated for recurrent disease (n = 6). Abdomino-perineal resection and radiotherapy resulted in an actuarial local control (LC) rate of 90% and an overall 5-year survival rate of 77% (median follow-up, 48 months). All patients in Group 1 and 5 8 patients in Group 3 had locally controlled disease and were disease-free. The chemoradiation protocol resulted in a complete clinical response rate of 75% ( 18 24, one patient died during treatment) assessed 4-6 weeks after treatment. The colostomy-free local control rate with chemoradiation is 67% ( 16 24). Local control was 50% for all stages receiving 45-49 Gy and 90% for those patients receiving ?55 Gy but was not correlated with total 5-FU dose. Abdomino-perineal resection was performed to salvage six patients with persistent disease and two with recurrent disease, resulting in an overall local control rate of 92% ( 22 24). The actuarial survival was 96% (median follow-up, 14 months; range, 1-30). The acute complications of radiotherapy included diarrhea and perineal skin reactions that were increased by 5-FU infusion. However, diarrhea can be ameliorated by a modified treatment technique that reduces irradiation to the small intestine. For the entire patient group, minor late complications occurred in 23%, and major complications occurred in 9%.
KW - 5-FU
KW - Carcinoma of the anal canal
KW - Radiotherapy
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U2 - 10.1016/0360-3016(89)90520-8
DO - 10.1016/0360-3016(89)90520-8
M3 - Article
C2 - 2599903
AN - SCOPUS:0024819273
SN - 0360-3016
VL - 17
SP - 1153
EP - 1160
JO - International journal of radiation oncology, biology, physics
JF - International journal of radiation oncology, biology, physics
IS - 6
ER -