Definitive chemoradiotherapy for anal canal cancer: single-center experience
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Chemoradiotherapy (CRT) is a standard treatment for anal canal cancer although many patients with anal canal cancer undergo surgery in Japan. The efficacy of CRT for anal canal cancer was evaluated retrospectively.
Medical charts of 13 patients with anal canal cancer treated by definitive CRT from October 2004 to May 2016 were reviewed. Twelve patients had squamous cell carcinoma and one had adeno-squamous carcinoma. PET/CT simulation was performed in nine patients. The median total dose was 59.4 Gy (range 57.6–63.4 Gy) with fractions of 1.8–2.0 Gy. Ten patients received chemotherapy with mitomycin C (10 mg/m2) and fluorouracil (5-FU) (800 mg/m2 over 4 days) in weeks 1 and 5, while two patients were treated with cisplatin (40 mg) and 5-FU (750 mg over 5 days) in weeks 1 and 5. One elderly patient received radiotherapy (RT) alone.
All 13 patients were alive after a median follow-up period of 102 months (range 16–121 months). Local failure only occurred in the patient with adeno-squamous cell carcinoma, while there was no loco-regional recurrence or distant metastasis in the other 12 patients. The 5-year loco-regional control rate (LRC) and 5-year overall survival rate (OS) were 92% and 100%, respectively. Acute toxicities of ≥ grade 3 were observed in six patients (46%), mainly being dermatitis around the anal verge, and late toxicity of ≥ grade 3 occurred in one patient.
CRT for squamous cell carcinoma of the anal canal achieved good LRC and OS with acceptable toxicities.
KeywordsAnal canal cancer Chemoradiotherapy Intensity-modulated radiation therapy Squamous cell carcinoma
This study was partly supported by the National Cancer Center Research and Development Fund (Grant no. 29-A-3).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.UKCCCR Anal Cancer Trial Working Party (1996) Epidermoid anal cancer: results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycin. Lancet 19(9034):1049–1054 348(Google Scholar
- 3.Bartelink H, Roelofsen F, Eschwege F et al (1997) Concomitant radiotherapy and chemotherapy is superior to radiotherapy alone in the treatment of locally advanced anal cancer: results of a phase III randomized trial of the European Organization for Research and Treatment of Cancer Radiotherapy and Gastrointestinal Cooperative Groups. J Clin Oncol 15(5):2040–2049CrossRefGoogle Scholar
- 4.Gunderson LL, Winter KA, Ajani JA et al (2012) Long-term update of US GI intergroup RTOG 98-11 phase III trial for anal carcinoma: survival, relapse, and colostomy failure with concurrent chemoradiation involving fluorouracil/mitomycin versus fluorouracil/cisplatin. J Clin Oncol 30(35):4344–4351CrossRefGoogle Scholar
- 9.Flam M, John M, Pajak TF et al (1996) Role of mitomycin in combination with fluorouracil and radiotherapy, and of salvage chemoradiation in the definitive nonsurgical treatment of epidermoid carcinoma of the anal canal: results of a phase III randomized intergroup study. J Clin Oncol 14(9):2527–2539CrossRefGoogle Scholar
- 11.Japanese Society for Therapeutic Radiology and Oncology (2016) The guideline for radiotherapy planning. Kanehara Shuppan, Tokyo (in Japanese) Google Scholar
- 13.NCCN Guidelines Version 2.2017 Anal Carcinoma. http://www.tri-kobe.org/nccn/guideline/colorectal/english/anal.pdf. Accessed 21 Feb 2018