TY - JOUR
T1 - Radiotherapy with intensity-modulated (Imrt) techniques in the treatment of anal carcinoma (rainstorm): A multicenter study on behalf of airo (Italian association of radiotherapy and clinical oncology) gastrointestinal study group
AU - Caravatta, Luciana
AU - Mantello, Giovanna
AU - Valvo, Francesca
AU - Franco, Pierfrancesco
AU - Gasparini, Lucrezia
AU - Rosa, Consuelo
AU - Slim, Najla
AU - Manfrida, Stefania
AU - De Felice, Francesca
AU - Gerardi, Marianna A.
AU - Vagge, Stefano
AU - Krengli, Marco
AU - Palazzari, Elisa
AU - Osti, Maria Falchetto
AU - Gonnelli, Alessandra
AU - Catalano, Gianpiero
AU - Pittoni, Patrizia
AU - Ivaldi, Giovani Battista
AU - Galardi, Alessandra
AU - Lupattelli, Marco
AU - Rosetto, Maria Elena
AU - Niespolo, Rita Marina
AU - Guido, Alessandra
AU - Durante, Oreste
AU - Macchia, Gabriella
AU - Munoz, Fernando
AU - El Khouzai, Badr
AU - Lucido, Maria Rosaria
AU - Porreca, Annamaria
AU - Porreca, Angelo
AU - Di Nicola, Marta
AU - Gambacorta, Maria Antonietta
AU - Donato, Vittorio
AU - Genovesi, Domenico
PY - 2021
Y1 - 2021
N2 - A multi-institutional retrospective study was conducted to evaluate the pattern of care and clinical outcomes of anal cancer patients treated with intensity-modulated radiotherapy (IMRT) techniques. In a cohort of 987 patients, the clinical complete response (CR) rate (beyond 6 months) was 90.6%. The 3-year local control (LC) rate was 85.8% (95% CI: 84.4–87.2), and the 3-year colostomy-free survival (CFS) rate was 77.9% (95% CI: 76.1–79.8). Three-year progression-free survival (PFS) and overall survival (OS) rates were 80.2% and 88.1% (95% CI: 78.8–89.4) (95% CI: 78.5–81.9), respectively. Histological grade 3 and nodal involvement were associated with lower CR (p = 0.030 and p = 0.004, respectively). A statistically significant association was found between advanced stage and nodal involvement, and LC, CFS, PFS, OS and event-free survival (EFS). Overall treatment time (OTT) ≥45 days showed a trend for a lower PFS (p = 0.050) and was significantly associated with lower EFS (p = 0.030) and histological grade 3 with a lower LC (p = 0.025). No statistically significant association was found between total dose, dose/fraction and/or boost modality and clinical outcomes. This analysis reports excellent clinical results and a mild toxicity profile, confirming IMRT techniques as standard of care for the curative treatment of anal cancer patients. Lymph node involvement and histological grade have been confirmed as the most important negative prognostic factors.
AB - A multi-institutional retrospective study was conducted to evaluate the pattern of care and clinical outcomes of anal cancer patients treated with intensity-modulated radiotherapy (IMRT) techniques. In a cohort of 987 patients, the clinical complete response (CR) rate (beyond 6 months) was 90.6%. The 3-year local control (LC) rate was 85.8% (95% CI: 84.4–87.2), and the 3-year colostomy-free survival (CFS) rate was 77.9% (95% CI: 76.1–79.8). Three-year progression-free survival (PFS) and overall survival (OS) rates were 80.2% and 88.1% (95% CI: 78.8–89.4) (95% CI: 78.5–81.9), respectively. Histological grade 3 and nodal involvement were associated with lower CR (p = 0.030 and p = 0.004, respectively). A statistically significant association was found between advanced stage and nodal involvement, and LC, CFS, PFS, OS and event-free survival (EFS). Overall treatment time (OTT) ≥45 days showed a trend for a lower PFS (p = 0.050) and was significantly associated with lower EFS (p = 0.030) and histological grade 3 with a lower LC (p = 0.025). No statistically significant association was found between total dose, dose/fraction and/or boost modality and clinical outcomes. This analysis reports excellent clinical results and a mild toxicity profile, confirming IMRT techniques as standard of care for the curative treatment of anal cancer patients. Lymph node involvement and histological grade have been confirmed as the most important negative prognostic factors.
KW - Anal carcinoma
KW - Concomitant radio-chemotherapy
KW - Intensity-modulated radiotherapy
KW - Simultaneous integrated boost
KW - Anal carcinoma
KW - Concomitant radio-chemotherapy
KW - Intensity-modulated radiotherapy
KW - Simultaneous integrated boost
UR - http://hdl.handle.net/10807/198586
U2 - 10.3390/cancers13081902
DO - 10.3390/cancers13081902
M3 - Article
SN - 2072-6694
VL - 13
SP - N/A-N/A
JO - Cancers
JF - Cancers
ER -