Abstract
Radio-chemotherapy (RCT) is the primary treatment of anal cancer (AC). However, the role and the optimal total dose of a radiation boost is still unclear. No randomized controlled trials nor systematic reviews have been performed to analyze the efficacy of brachytherapy (BRT) as boost in AC. Therefore, we performed this systematic review based on PRISMA methodology to establish the role of BRT boost in AC. A systematic search of the bibliographic databases: PubMed, Scopus, and Cochrane library from the earliest possible date through January 31, 2018 was performed. At least one of the following outcomes: local control (LC), loco-regional control (LRC), overall survival (OS), disease-free survival (DFS), or colostomy-free survival (CFS) had to be present for inclusion in this systematic review in patients receiving a BRT boost. Data about toxicity and sphincter function were also included. Ten articles fulfilled the inclusion criteria. All the studies had retrospective study design. All studies were classified to provide a level of evidence graded as 3 according to SIGN classification. Median 5-year LC/LRC, CFS, DFS, and OS were: 78.6% (range, 70.7-92.0%), 76.1% (range, 61.4-86.4%), 75.8% (range, 65.9-85.7%), and 69.4% (63.4-82.0%), respectively. The reported toxicities were acceptable. RCT is the treatment cornerstone in AC. High-level evidences from studies on BRT boost in AC are lacking. Further studies should investigate: efficacy of BRT boost in comparison to no boost and to external beam boost, patients who can benefit from this treatment intensification, and optimal radiation dose.
| Original language | English |
|---|---|
| Pages (from-to) | 246-253 |
| Number of pages | 8 |
| Journal | Journal of Contemporary Brachytherapy |
| Volume | 10 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Jan 1 2018 |
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Keywords
- Anal cancer
- Brachytherapy boost
- Systematic review
ASJC Scopus subject areas
- Oncology
- Radiology Nuclear Medicine and imaging
Cite this
Brachytherapy boost after chemoradiation in anal cancer : A systematic review. / Frakulli, Rezarta; Buwenge, Milly; Cammelli, Silvia; Macchia, Gabriella; Farina, Eleonora; Arcelli, Alessandra; Ferioli, Martina; Fuccio, Lorenzo; Tagliaferri, Luca; Galuppi, Andrea; Frezza, Giovanni P.; Morganti, Alessio G.
In: Journal of Contemporary Brachytherapy, Vol. 10, No. 3, 01.01.2018, p. 246-253.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Brachytherapy boost after chemoradiation in anal cancer
T2 - A systematic review
AU - Frakulli, Rezarta
AU - Buwenge, Milly
AU - Cammelli, Silvia
AU - Macchia, Gabriella
AU - Farina, Eleonora
AU - Arcelli, Alessandra
AU - Ferioli, Martina
AU - Fuccio, Lorenzo
AU - Tagliaferri, Luca
AU - Galuppi, Andrea
AU - Frezza, Giovanni P.
AU - Morganti, Alessio G.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Radio-chemotherapy (RCT) is the primary treatment of anal cancer (AC). However, the role and the optimal total dose of a radiation boost is still unclear. No randomized controlled trials nor systematic reviews have been performed to analyze the efficacy of brachytherapy (BRT) as boost in AC. Therefore, we performed this systematic review based on PRISMA methodology to establish the role of BRT boost in AC. A systematic search of the bibliographic databases: PubMed, Scopus, and Cochrane library from the earliest possible date through January 31, 2018 was performed. At least one of the following outcomes: local control (LC), loco-regional control (LRC), overall survival (OS), disease-free survival (DFS), or colostomy-free survival (CFS) had to be present for inclusion in this systematic review in patients receiving a BRT boost. Data about toxicity and sphincter function were also included. Ten articles fulfilled the inclusion criteria. All the studies had retrospective study design. All studies were classified to provide a level of evidence graded as 3 according to SIGN classification. Median 5-year LC/LRC, CFS, DFS, and OS were: 78.6% (range, 70.7-92.0%), 76.1% (range, 61.4-86.4%), 75.8% (range, 65.9-85.7%), and 69.4% (63.4-82.0%), respectively. The reported toxicities were acceptable. RCT is the treatment cornerstone in AC. High-level evidences from studies on BRT boost in AC are lacking. Further studies should investigate: efficacy of BRT boost in comparison to no boost and to external beam boost, patients who can benefit from this treatment intensification, and optimal radiation dose.
AB - Radio-chemotherapy (RCT) is the primary treatment of anal cancer (AC). However, the role and the optimal total dose of a radiation boost is still unclear. No randomized controlled trials nor systematic reviews have been performed to analyze the efficacy of brachytherapy (BRT) as boost in AC. Therefore, we performed this systematic review based on PRISMA methodology to establish the role of BRT boost in AC. A systematic search of the bibliographic databases: PubMed, Scopus, and Cochrane library from the earliest possible date through January 31, 2018 was performed. At least one of the following outcomes: local control (LC), loco-regional control (LRC), overall survival (OS), disease-free survival (DFS), or colostomy-free survival (CFS) had to be present for inclusion in this systematic review in patients receiving a BRT boost. Data about toxicity and sphincter function were also included. Ten articles fulfilled the inclusion criteria. All the studies had retrospective study design. All studies were classified to provide a level of evidence graded as 3 according to SIGN classification. Median 5-year LC/LRC, CFS, DFS, and OS were: 78.6% (range, 70.7-92.0%), 76.1% (range, 61.4-86.4%), 75.8% (range, 65.9-85.7%), and 69.4% (63.4-82.0%), respectively. The reported toxicities were acceptable. RCT is the treatment cornerstone in AC. High-level evidences from studies on BRT boost in AC are lacking. Further studies should investigate: efficacy of BRT boost in comparison to no boost and to external beam boost, patients who can benefit from this treatment intensification, and optimal radiation dose.
KW - Anal cancer
KW - Brachytherapy boost
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85052405284&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85052405284&partnerID=8YFLogxK
U2 - 10.5114/jcb.2018.76884
DO - 10.5114/jcb.2018.76884
M3 - Review article
AN - SCOPUS:85052405284
VL - 10
SP - 246
EP - 253
JO - Journal of Contemporary Brachytherapy
JF - Journal of Contemporary Brachytherapy
SN - 1689-832X
IS - 3
ER -