Image-guided SIB-IMRT for the treatment of anal cancer patients in Radiotherapy and Oncology
2017
AOU Città della Salute di Torino
Tipo pubblicazione
Conference Abstract
Autori/Collaboratori (10)Vedi tutti...
Arcadipane F
Franco P
Martini S
et alii...
Abstract
Purpose or Objective Concurrent chemoradiation (CT-RT) has been established as the standard of care for anal cancer patients. We explored intensity-modulated and image-guided radiotherapy (IMRT-IGRT) with a simultaneous integrated boost (SIB) approach reporting on clinical outcomes within a mono-istitutional observational study. Material and Methods Between April 2007 and April 2015, 87 patients with biopsy proven squamous cell anal cancer were treated with SIBIMRT. Radiotherapy was delivery using a schedule of 50.4/54 Gy to the primary tumor and involved lymphnodes and 42/45 Gy to the elective volumes. Dose prescription varied according to clinical stage, following Radiation Therapy Oncology Group (RTOG) 0529 indications. Concurrent 5-Fluorouracil and Mitomycin-C were given. Clinical data and toxicity are herein reported. Results A total of 87 patients (stage I 6%; II 56%; III 38%) were treated and observed for median time of 34 months (range: 9-102). CT-RT with MMC and 5-FU was administered in 90.8% of patients. One patient received MMC only, two patients 5-FU only and five patients underwent exclusive RT, after consderation of age, comorbidities and performance status. The 3-year rates of colostomy-free survival, local control, disease free and overall survival were 71% (95% CI 0.59-0.80), 69% (95% CI 0.57-0.79), 64% (95% CI 0.52-0.75), and 79% (95% CI 0.66- 0.87) respectively (Figure 1). At the time of analysis 20/87 (23%) patients were dead and 14 death were related to cancer. Up to 23 patients recurred; ten failed locally, 7 failed both locally and distantly and 6 developed systemic failure only. Seventy-seven patients reached a clinical complete response six months after treatment (88.5%). Major acute toxicity events (>G3) were recorded for gastrointestinal (6.9%), genitourinary (1.2%) and hematologic (neutropenia: 19.6%) aspects. Borderline significance as prognostic factors with respect to CFS were found for gender and stage (Table 1). Conclusion Ima
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Keywords
anus cancer; adult; mitomycin; acute toxicity; fluorouracil; biopsy; cancer patient; cancer prognosis; cancer recurrence; cancer staging; cancer survival; chemoradiotherapy; clinical outcome; colostomy; comorbidity; death; disease free survival; drug combination; drug therapy; female; gastrointestinal tract; gender; human; human cell; human tissue; image guided radiotherapy; lymph node; major clinical study; male; neutropenia; observational study; overall survival; prescription; primary tumor; radiotherapy; remission; squamous cell;