Abstract | PURPOSE: METHODS: Between 2000 and 2015, a total of 112 consecutive patients with UICC stage I-IV anal cancer received chemoradiotherapy with 5‑fluororuracil and mitomycin C (CRT). In case of insufficient tumor response 4-6 weeks after chemoradiotherapy, patients received an interstitial pulsed-dose-rate brachytherapy boost. Additionally, 50/112 patients received hyperthermia treatments (HCRT). RESULTS: Median follow-up was 41 (2-165) months. After 5 years follow-up, overall (95.8 vs. 74.5%, P = 0.045), disease-free (89.1 vs. 70.4%, P = 0.027), local recurrence-free (97.7 vs. 78.7%, P = 0.006), and colostomy-free survival rates (87.7 vs. 69.0%, P = 0.016) were better for the HCRT group. Disease-specific, regional failure-free, and distant metastasis-free survival rates showed no significant differences. The adjusted hazard ratios for death were 0.25 (95% CI, 0.07 to 0.92; P = 0.036) and for local recurrence 0.14 (95% CI, 0.02 to 1.09; P = 0.06), respectively. Grades 3-4 early toxicities were comparable with the exception of hematotoxicity, which was higher in the HCRT group (66 vs. 43%, P = 0.032). Incidences of late side effects were similar with the exception of a higher telangiectasia rate in the HCRT group (38.0 vs. 16.1%, P = 0.009). CONCLUSION: Additional regional hyperthermia improved overall survival, local control, and colostomy rates. Its potential beneficial role has to be confirmed in a prospective randomized setting. Therefore, the HyCAN trial has already been established by our group and is currently recruiting patients (Clinicaltrials.gov identifier: NCT02369939).
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Authors | Oliver J Ott, Manfred Schmidt, Sabine Semrau, Vratislav Strnad, Klaus E Matzel, Ignaz Schneider, Dimitrios Raptis, Wolfgang Uter, Robert Grützmann, Rainer Fietkau |
Journal | Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
(Strahlenther Onkol)
Vol. 195
Issue 7
Pg. 607-614
(Jul 2019)
ISSN: 1439-099X [Electronic] Germany |
Vernacular Title | Radiochemotherapie mit und ohne regionale Tiefenhyperthermie bei Plattenepithelkarzinomen des Anus. |
PMID | 30390114
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Anus Neoplasms
(pathology, therapy)
- Brachytherapy
(methods)
- Carcinoma, Squamous Cell
(pathology, therapy)
- Chemoradiotherapy
- Colostomy
- Combined Modality Therapy
- Disease-Free Survival
- Female
- Fluorouracil
(administration & dosage)
- Follow-Up Studies
- Humans
- Hyperthermia, Induced
(methods)
- Male
- Middle Aged
- Mitomycin
(administration & dosage)
- Neoplasm Staging
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