Document Detail


Intensity-modulated radiation therapy for anal malignancies: a preliminary toxicity and disease outcomes analysis.
MedLine Citation:
PMID:  20231064     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Intensity-modulated radiation therapy (IMRT) has the potential to reduce toxicities associated with chemoradiotherapy in the treatment of anal cancer. This study reports the results of using IMRT in the treatment of anal cancer.
METHODS AND MATERIALS: Records of patients with anal malignancies treated with IMRT at Duke University were reviewed. Acute toxicity was graded using the NCI CTCAEv3.0 scale. Overall survival (OS), metastasis-free survival (MFS), local-regional control (LRC) and colostomy-free survival (CFS) were calculated using the Kaplan-Meier method.
RESULTS: Forty-seven patients with anal malignancy (89% canal, 11% perianal skin) were treated with IMRT between August 2006 and September 2008. Median follow-up was 14 months (19 months for SCC patients). Median radiation dose was 54 Gy. Eight patients (18%) required treatment breaks lasting a median of 5 days (range, 2-7 days). Toxicity rates were as follows: Grade 4: leukopenia (7%), thrombocytopenia (2%); Grade 3: leukopenia (18%), diarrhea (9%), and anemia (4%); Grade 2: skin (93%), diarrhea (24%), and leukopenia (24%). The 2-year actuarial overall OS, MFS, LRC, and CFS rates were 85%, 78%, 90% and 82%, respectively. For SCC patients, the 2-year OS, MFS, LRC, and CFS rates were 100%, 100%, 95%, and 91%, respectively.
CONCLUSIONS: IMRT-based chemoradiotherapy for anal cancer results in significant reductions in normal tissue dose and acute toxicities versus historic controls treated without IMRT, leading to reduced rates of toxicity-related treatment interruption. Early disease-related outcomes seem encouraging. IMRT is emerging as a standard therapy for anal cancer.
Authors:
Joseph M Pepek; Christopher G Willett; Q Jackie Wu; Sua Yoo; Robert W Clough; Brian G Czito
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Publication Detail:
Type:  Journal Article     Date:  2010-03-16
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  78     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2010-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1413-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Radiation Oncology, Duke University School of Medicine, Durham, NC 27710, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / radiotherapy
Adolescent
Adult
Aged
Aged, 80 and over
Anemia / etiology
Anus Neoplasms / radiotherapy*
Carcinoma, Squamous Cell / radiotherapy
Diarrhea / etiology
Female
Humans
Leukopenia / etiology
Male
Melanoma / radiotherapy
Middle Aged
Neuroendocrine Tumors / radiotherapy
Radiotherapy Dosage
Radiotherapy, Intensity-Modulated / adverse effects*,  methods
Rhabdomyosarcoma / radiotherapy
Sarcoma / radiotherapy
Thrombocytopenia / etiology
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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