Long-Term Outcome after Combined Radiochemotherapy for Anal Cancer – Retrospective Analysis of Efficacy, Prognostic Factors, and ToxicityMai S.K. · Welzel G. · Hermann B. · Bohrer M. · Wenz F.
Department of Radiation Oncology, University Medical Center Mannheim, Germany
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.
© 2008 S. Karger AG, Basel
Dr. med. Sabine K. Mai, Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim, Theodor-Kutzer Ufer 1–3, 68167 Mannheim, Germany Tel. +49 621 3833-530, Fax -493, E-mail firstname.lastname@example.org
Published online: April 18, 2008
Number of Print Pages : 7
Number of Figures : 5, Number of Tables : 6, Number of References : 41
Onkologie (International Journal for Cancer Research and Treatment)
Vol. 31, No. 5, Year 2008 (Cover Date: May 2008)
Journal Editor: Schmoll H.-J. (Halle)
ISSN: 0378–584X (Print), eISSN: 1423–0240 (Online)
For additional information: http://www.karger.com/ONK