Impact of Overall Treatment Time on Local Control of Anal Cancer Treated with RadiochemotherapyGraf R.a · Wust P.a · Hildebrandt B.b · Gögler H.c · Ullrich R.a · Herrmann R.d · Riess H.b · Felix R.a
aCenter of Radiation Medicine and bMedical Clinic for Hematology and Oncology, Campus Virchow Clinic, Charité Medical School, Humboldt University, and cSurgical Department, DRK Hospital, Westend Clinics, Berlin, Germany; dDepartment of Oncology, University Hospital Basel, Basel, Switzerland
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Between 1987 and 2000, 111 patients with epidermoid anal cancer (T1–T4 Nx M0) were assigned to primary simultaneous radiochemotherapy (RCT) with a radiation dose of 45 Gy, performed either as a split course with 2-Gy single fractions (schedule A, 1987–1996, n = 65 patients) or continuously with fractions of 1.8 Gy (schedule B, 1996–2000; n = 38 patients). The chemotherapy consisted of continuous infusions of 5-fluorouracil (5-FU; 800/1,000 mg/m2/day, on 4/5 consecutive days, during weeks 1 and 5) together with one (schedule A) or two (schedule B) short infusions of mitomycin C (10 mg/m2) during the first course of 5-FU. Associations between clinical outcome and various prognostic factors were assessed in 103 patients who completed these schedules. For both patient groups combined, 5-year local control rate was 67% and 5-year survival rate 71%. Advanced tumor stage, size, and nodal status significantly decreased the 5-year local control rate as well as the overall treatment time (OTT) >41 days (58% for OTT >41 days vs. 79% for OTT ≤41 days; p = 0.04). However, we did not find a correlation with the prescribed radiotherapy schedule (A or B). In conclusion, in patients with anal carcinomas treated with RCT with a radiation dose of 45 Gy, the predominant determinant of local control is the resulting OTT and not the administration schedule (split course or continuous radiotherapy).
© 2003 S. Karger AG, Basel
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