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Capecitabine/cisplatin combined with concurrent intensity-modulated radiation therapy: a feasible therapeutic strategy for anal squamous cell carcinoma

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Abstract

Purpose

To evaluate the efficacy and safety of capecitabine/cisplatin (XP) combined with intensity-modulated radiation therapy (IMRT) in patients with non-metastatic anal squamous cell carcinoma (ASCC).

Method and materials

All patients with ASCC who received radical concurrent chemoradiotherapy in the past 8 years were screened. Patients who received XP or mitomycin/5-fluorouracil (MF) were selected and analyzed retrospectively.

Results

ASCC is an uncommon cancer, there were 36 patients were included in our study. The XP group and MF group included 18 patients each. The clinical complete response (cCR) rates in the XP group and the MF group were 94.4% and 88.9%, respectively (P = 1). The 2-year local control (LC), disease-free survival (DFS), and colostomy-free survival (CFS) rates were higher in the XP group than in the MF group (100% vs 93.3%, P = 0.32). Hematologic toxicities, especially grade ≥ 3 leukopenia (11.1% vs 44.4%, P = 0.06) and neutropenia (5.6% vs 61.1%, P = 0.001), were lower in the XP group than MF group. As a result of fewer side effects, fewer patients in the XP group demanded the dose reduction of chemotherapy (11.1% vs 50%, P = 0.03) and radiation interruption (55.6% vs 77.8%, P = 0.289). Delayed radiotherapy was shorter in the XP group (2.5 vs 6.5 days, P = 0.042) than in the MF group.

Conclusion

The XP regimen was as effective as the MF regimen in non-metastatic ASCC. Compared with the standard MF regimen, XP combined with IMRT showed higher treatment completion and lower toxicities. It could be considered a feasible alternative for patients with non-metastatic ASCC.

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Data availability

The data analysed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Division of Abdominal Tumor Multimodlity, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, China

    Jielang Li & Chen Huang

  2. Abdominal Oncology Ward, Division of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, China

    Xin Wang, Zhiping Li & Yali Shen

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  1. Jielang Li
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  2. Chen Huang
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  3. Xin Wang
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Contributions

LJ and SY conceived the idea. WX, LZ and SY were responsible for the clinical care of patients. Data collection and analysis were performed by LJ and HC. The first draft of the manuscript was written by LJ and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yali Shen.

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The authors declare they have no conflicts of interest. The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

This study was approved by the Ethics Committee of West China hospital, Sichuan University China (No.20201000).

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Informed consent was obtained from all individual participants included in the study.

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Li, J., Huang, C., Wang, X. et al. Capecitabine/cisplatin combined with concurrent intensity-modulated radiation therapy: a feasible therapeutic strategy for anal squamous cell carcinoma. Clin Transl Oncol 26, 739–746 (2024). https://doi.org/10.1007/s12094-023-03296-1

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