Node-negative T1-T2 anal cancer: radiotherapy alone or concomitant chemoradiotherapy?

Abstract

PURPOSE:

To evaluate the influence of concomitant chemotherapy on loco-regional control (LRC) and cancer-specific survival (CSS) in patients with T1-T2 N0 M0 anal cancer treated conservatively by primary radiotherapy (RT).

MATERIALS AND METHODS:

Between 1976 and 2008, 146 patients with T1 (n=29) or T2 (n=117) N0 M0 anal cancer were treated curatively by RT alone (n=71) or by combined chemoradiotherapy (CRT) (n=75) consisting of mitomycin C±5-fluorouracil. Univariate and multivariate analyses were performed to assess patient-, tumor- and treatment-related factors influencing LRC and CSS.

RESULTS:

With a median follow-up of 62.5 months (interquartilerange, 26-113 months), 122 (84%) patients were locally controlled. The five-year actuarial LRC, CSS and overall survival for the population were 81.4%±3.6%, 91.9%±2.6%, and 75.4%±3.9%, respectively. The five-year LRC and CSS for patients treated with RT alone and with CRT were 75.5%±6.0% vs. 86.8%±4.1% (p=0.155) and 88.5%±4.5% vs. 94.9%±2.9% (p=0.161), respectively. In the multivariate analysis, no clinical or therapeutic factors were found to significantly influence the LRC and CSS, while the addition of chemotherapy was of borderline significance (p=0.065 and p=0.107, respectively).

CONCLUSIONS:

In the management of node negative T1-T2 anal cancer, LRC and CSS tend to be superior in patients treated by combined CRT, even though the difference was not significant. Randomized studies are warranted to assess definitively the role of combined treatment in early-stage anal carcinoma.

• Authors: Thomas Zilli, Ulrike Schick, Mahmut Ozsahin, Pascal Gervaz, Arnaud D Roth, Abdelkarim S Allal
• Journal: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology (Radiother Oncol) Vol. 102 Issue 1 Pg. 62-7 (Jan 2012) ISSN: 1879-0887 [Electronic] Ireland
• PMID: 21993403 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Mitomycin
• Fluorouracil

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Anus Neoplasms (pathology, therapy)
• Chemoradiotherapy (methods)
• Combined Modality Therapy
• Female
• Fluorouracil (administration & dosage)
• Humans
• Male
• Middle Aged
• Mitomycin (administration & dosage)
• Neoplasm Staging
• Survival Rate
• Treatment Outcome