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Intensity modulated radiotherapy for anal canal squamous cell carcinoma: A 16-year single institution experience
INTRODUCTION: To report long-term efficacy and adverse events (AEs) associated with intensity modulated radiotherapy (IMRT) for patients with anal canal squamous cell carcinoma (ASCC). MATERIALS AND METHODS: This was a retrospective review of patients with ASCC who received curative-intent IMRT and...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7943964/ https://www.ncbi.nlm.nih.gov/pubmed/33732911 http://dx.doi.org/10.1016/j.ctro.2021.02.002 |
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author | Jethwa, Krishan R. Day, Courtney N. Sandhyavenu, Harigopal Gonuguntla, Karthik Harmsen, William S. Breen, William G. Routman, David M. Garda, Allison E. Hubbard, Joleen M. Halfdanarson, Thorvardur R. Neben-Wittich, Michelle A. Merrell, Kenneth W. Hallemeier, Christopher L. Haddock, Michael G. |
author_facet | Jethwa, Krishan R. Day, Courtney N. Sandhyavenu, Harigopal Gonuguntla, Karthik Harmsen, William S. Breen, William G. Routman, David M. Garda, Allison E. Hubbard, Joleen M. Halfdanarson, Thorvardur R. Neben-Wittich, Michelle A. Merrell, Kenneth W. Hallemeier, Christopher L. Haddock, Michael G. |
author_sort | Jethwa, Krishan R. |
collection | PubMed |
description | INTRODUCTION: To report long-term efficacy and adverse events (AEs) associated with intensity modulated radiotherapy (IMRT) for patients with anal canal squamous cell carcinoma (ASCC). MATERIALS AND METHODS: This was a retrospective review of patients with ASCC who received curative-intent IMRT and concurrent chemotherapy (98%) between 2003 and 2019. Overall survival (OS), colostomy-free survival (CFS), and progression-free survival (PFS) were estimated using the Kaplan-Meier method. The cumulative incidence of local recurrence (LR), locoregional recurrence (LRR), and distant metastasis (DM) were reported. Acute and late AEs were recorded per National Cancer Institute Common Terminology Criteria for AEs. RESULTS: 127 patients were included. The median patient age was 63 years (interquartile range [IQR] 55–69) and 79% of patients were female. 33% of patients had T3-4 disease and 68% had clinically involved pelvic or inguinal lymph nodes (LNs). The median patient follow-up was 47 months (IQR: 28–89 months). The estimated 4-year OS, CFS, and PFS were 81% (95% confidence interval [CI]: 73%–89%), 77% (95% CI: 68%–86%), and 78% (95% CI: 70%–86%), respectively. The 4-year cumulative incidences of LR, LRR, and DM were 3% (95% CI: 1%–9%), 9% (95% CI: 5%–17%), and 10% (95% CI: 6%–18%), respectively. Overall treatment duration greater than 39 days was associated with an increased risk of LRR (Hazard Ratio [HR]: 5.2, 95% CI: 1.4–19.5, p = 0.015). The most common grade 3+ acute AEs included hematologic (31%), gastrointestinal (GI) (17%), dermatologic (16%), and pain (15%). Grade 3+ late AEs included: GI (3%), genitourinary (GU) (2%), and pain (1%). Current smokers were more likely to experience grade 3+ acute dermatologic toxicity compared to former or never smokers (34% vs. 7%, p < 0.001). CONCLUSIONS: IMRT was associated with favorable toxicity rates and long-term efficacy. These data support the continued utilization of IMRT as the preferred treatment technique for patients with ASCC. |
format | Online Article Text |
id | pubmed-7943964 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-79439642021-03-16 Intensity modulated radiotherapy for anal canal squamous cell carcinoma: A 16-year single institution experience Jethwa, Krishan R. Day, Courtney N. Sandhyavenu, Harigopal Gonuguntla, Karthik Harmsen, William S. Breen, William G. Routman, David M. Garda, Allison E. Hubbard, Joleen M. Halfdanarson, Thorvardur R. Neben-Wittich, Michelle A. Merrell, Kenneth W. Hallemeier, Christopher L. Haddock, Michael G. Clin Transl Radiat Oncol Article INTRODUCTION: To report long-term efficacy and adverse events (AEs) associated with intensity modulated radiotherapy (IMRT) for patients with anal canal squamous cell carcinoma (ASCC). MATERIALS AND METHODS: This was a retrospective review of patients with ASCC who received curative-intent IMRT and concurrent chemotherapy (98%) between 2003 and 2019. Overall survival (OS), colostomy-free survival (CFS), and progression-free survival (PFS) were estimated using the Kaplan-Meier method. The cumulative incidence of local recurrence (LR), locoregional recurrence (LRR), and distant metastasis (DM) were reported. Acute and late AEs were recorded per National Cancer Institute Common Terminology Criteria for AEs. RESULTS: 127 patients were included. The median patient age was 63 years (interquartile range [IQR] 55–69) and 79% of patients were female. 33% of patients had T3-4 disease and 68% had clinically involved pelvic or inguinal lymph nodes (LNs). The median patient follow-up was 47 months (IQR: 28–89 months). The estimated 4-year OS, CFS, and PFS were 81% (95% confidence interval [CI]: 73%–89%), 77% (95% CI: 68%–86%), and 78% (95% CI: 70%–86%), respectively. The 4-year cumulative incidences of LR, LRR, and DM were 3% (95% CI: 1%–9%), 9% (95% CI: 5%–17%), and 10% (95% CI: 6%–18%), respectively. Overall treatment duration greater than 39 days was associated with an increased risk of LRR (Hazard Ratio [HR]: 5.2, 95% CI: 1.4–19.5, p = 0.015). The most common grade 3+ acute AEs included hematologic (31%), gastrointestinal (GI) (17%), dermatologic (16%), and pain (15%). Grade 3+ late AEs included: GI (3%), genitourinary (GU) (2%), and pain (1%). Current smokers were more likely to experience grade 3+ acute dermatologic toxicity compared to former or never smokers (34% vs. 7%, p < 0.001). CONCLUSIONS: IMRT was associated with favorable toxicity rates and long-term efficacy. These data support the continued utilization of IMRT as the preferred treatment technique for patients with ASCC. Elsevier 2021-02-23 /pmc/articles/PMC7943964/ /pubmed/33732911 http://dx.doi.org/10.1016/j.ctro.2021.02.002 Text en © 2021 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Article Jethwa, Krishan R. Day, Courtney N. Sandhyavenu, Harigopal Gonuguntla, Karthik Harmsen, William S. Breen, William G. Routman, David M. Garda, Allison E. Hubbard, Joleen M. Halfdanarson, Thorvardur R. Neben-Wittich, Michelle A. Merrell, Kenneth W. Hallemeier, Christopher L. Haddock, Michael G. Intensity modulated radiotherapy for anal canal squamous cell carcinoma: A 16-year single institution experience |
title | Intensity modulated radiotherapy for anal canal squamous cell carcinoma: A 16-year single institution experience |
title_full | Intensity modulated radiotherapy for anal canal squamous cell carcinoma: A 16-year single institution experience |
title_fullStr | Intensity modulated radiotherapy for anal canal squamous cell carcinoma: A 16-year single institution experience |
title_full_unstemmed | Intensity modulated radiotherapy for anal canal squamous cell carcinoma: A 16-year single institution experience |
title_short | Intensity modulated radiotherapy for anal canal squamous cell carcinoma: A 16-year single institution experience |
title_sort | intensity modulated radiotherapy for anal canal squamous cell carcinoma: a 16-year single institution experience |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7943964/ https://www.ncbi.nlm.nih.gov/pubmed/33732911 http://dx.doi.org/10.1016/j.ctro.2021.02.002 |
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