Document Detail


Successful Closure of Anal Cancer-Related Fistulas With Upfront Intra-arterial Chemotherapy: a Report of 8 Cases.
MedLine Citation:
PMID:  21471757     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: : Fistulas arising from the perforation of anal cancer into adjacent organs are a debilitating complication in the course of the disease.
OBJECTIVE: : We studied intra-arterial chemotherapy as a strategy to close such fistulas before the initiation of standard chemoradiation.
DESIGN: : This study was based on a retrospective chart review.
SETTING: : The investigation was conducted at Geneva University Hospital.
PATIENTS: : Eight patients with anal cancer-related fistulas were included in the study.
INTERVENTION: : Patients were treated at our institution from 2002 to 2009 with upfront chemotherapy consisting of 1 to 4 cycles of intra-arterial cisplatin, 5-fluorouracil, methotrexate, and mitomycin C, and intravenous bleomycin. Intra-arterial chemotherapy was followed by standard chemoradiation.
MAIN OUTCOME MEASURE: : Fistula closure was assessed by an expert proctologist.
RESULTS: : Complete closure of fistulas was documented in 7 of 8 patients. Toxicity was manageable and consisted mainly of thrombocytopenia, neutropenia, and febrile neutropenia as well as fatigue.
LIMITATIONS: : This is a retrospective, uncontrolled review of only 8 patients and thus a meaningful comparison with standard chemoradiation is not feasible.
CONCLUSION: : Upfront intra-arterial chemotherapy is a promising strategy to close anal cancer-related fistulas before initiating chemoradiation, potentially obviating the need for hazardous reconstructive surgery after radiotherapy.
Authors:
Robert Kridel; Stéphane Cochet; Bruno Roche; Albéric Bressoud; Pascal Gervaz; Michael Betz; Arnaud D Roth
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  54     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  566-9     Citation Subset:  IM    
Affiliation:
1 Division of Oncology, Geneva University Hospital, Geneva, Switzerland 2 Department of Surgery, Geneva University Hospital, Geneva, Switzerland 3 Division of Radio-oncology, Geneva University Hospital, Geneva, Switzerland 4 Oncosurgery, Geneva University Hospital, Geneva, Switzerland 5 Division of Oncology, Hôpital neuchâtelois-Pourtalès, Neuchâtel, Switzerland.
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