Radiation therapy of anal canal cancer: from conformal therapy to volumetric modulated arc therapy

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Abstract

BACKGROUND: To appraise the role of volumetric modulated arc (RapidArc, RA) in the treatment of anal canal carcinoma (ACC).

METHODS: A retrospective analysis has been conducted on 36 patients treated with RA since 2009 comparing outcome against a group of 28 patients treated with conformal therapy (CRT). RA treatments were prescribed with SIB technique with 59.4 Gy to the primary tumor and nodes and 49.5 Gy to the elective nodes. CRT was sequentially delivered with 45 Gy to the pelvic target and a boost of 14.4 Gy to the primary tumor.

RESULTS: Median age of patients was 65 yrs for RA (59 yrs for CRT); 90% had Stage II-III (93% in the CRT group). No statistically significant differences were observed concerning survival or control. 5 yrs disease specific survival was 85.7% and 81.2%, loco-regional control was of 78.1% and 82.1% for RA and CRT respectively. RA treatments lead to lower incidence of higher grade of toxicity events (all retrospectively retrieved from charts as worse events). Grade 2-3 toxicity, compared to CRT, reduced from 89% to 68% for GI, from 39% to 33% for GU and from 82% to 75% for the skin. Late toxicity was as follows: 5/36 (14%) and 3/36 (8%) patients had G1 or G2 GI toxicity in the RA group (1/28 (4%) and 4/28 (14%) in the CRT group). GU late toxicity was observed only in 4/28 (14%) patients of the CRT group: 3/28 (11%) had G2 and 1/28 (4%) had G1.

CONCLUSIONS: RA treatments of ACC patients proved to be equally effective than CRT but it was associated to a reduction of toxicity.

Original languageEnglish
Pages (from-to)833
Number of pages1
JournalBMC Cancer
Volume14
DOIs
Publication statusPublished - 2014

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Anus Neoplasms
Intensity-Modulated Radiotherapy
Anal Canal
Radiotherapy
Group Psychotherapy
Therapeutics
Survival
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{eec5ba79d5344a839115b4d81b3be529,
title = "Radiation therapy of anal canal cancer: from conformal therapy to volumetric modulated arc therapy",
abstract = "BACKGROUND: To appraise the role of volumetric modulated arc (RapidArc, RA) in the treatment of anal canal carcinoma (ACC).METHODS: A retrospective analysis has been conducted on 36 patients treated with RA since 2009 comparing outcome against a group of 28 patients treated with conformal therapy (CRT). RA treatments were prescribed with SIB technique with 59.4 Gy to the primary tumor and nodes and 49.5 Gy to the elective nodes. CRT was sequentially delivered with 45 Gy to the pelvic target and a boost of 14.4 Gy to the primary tumor.RESULTS: Median age of patients was 65 yrs for RA (59 yrs for CRT); 90{\%} had Stage II-III (93{\%} in the CRT group). No statistically significant differences were observed concerning survival or control. 5 yrs disease specific survival was 85.7{\%} and 81.2{\%}, loco-regional control was of 78.1{\%} and 82.1{\%} for RA and CRT respectively. RA treatments lead to lower incidence of higher grade of toxicity events (all retrospectively retrieved from charts as worse events). Grade 2-3 toxicity, compared to CRT, reduced from 89{\%} to 68{\%} for GI, from 39{\%} to 33{\%} for GU and from 82{\%} to 75{\%} for the skin. Late toxicity was as follows: 5/36 (14{\%}) and 3/36 (8{\%}) patients had G1 or G2 GI toxicity in the RA group (1/28 (4{\%}) and 4/28 (14{\%}) in the CRT group). GU late toxicity was observed only in 4/28 (14{\%}) patients of the CRT group: 3/28 (11{\%}) had G2 and 1/28 (4{\%}) had G1.CONCLUSIONS: RA treatments of ACC patients proved to be equally effective than CRT but it was associated to a reduction of toxicity.",
author = "Angelo Tozzi and Luca Cozzi and Cristina Iftode and Annamaria Ascolese and Campisi, {Maria C oncetta} and Elena Clerici and Tiziana Comito and {De Rose}, Fiorenza and Antonella Fogliata and Ciro Franzese and Pietro Mancosu and Piera Navarria and Stefano Tomatis and Elisa Villa and Marta Scorsetti",
year = "2014",
doi = "10.1186/1471-2407-14-833",
language = "English",
volume = "14",
pages = "833",
journal = "BMC Cancer",
issn = "1471-2407",
publisher = "BioMed Central Ltd.",

}

TY - JOUR

T1 - Radiation therapy of anal canal cancer

T2 - from conformal therapy to volumetric modulated arc therapy

AU - Tozzi, Angelo

AU - Cozzi, Luca

AU - Iftode, Cristina

AU - Ascolese, Annamaria

AU - Campisi, Maria C oncetta

AU - Clerici, Elena

AU - Comito, Tiziana

AU - De Rose, Fiorenza

AU - Fogliata, Antonella

AU - Franzese, Ciro

AU - Mancosu, Pietro

AU - Navarria, Piera

AU - Tomatis, Stefano

AU - Villa, Elisa

AU - Scorsetti, Marta

PY - 2014

Y1 - 2014

N2 - BACKGROUND: To appraise the role of volumetric modulated arc (RapidArc, RA) in the treatment of anal canal carcinoma (ACC).METHODS: A retrospective analysis has been conducted on 36 patients treated with RA since 2009 comparing outcome against a group of 28 patients treated with conformal therapy (CRT). RA treatments were prescribed with SIB technique with 59.4 Gy to the primary tumor and nodes and 49.5 Gy to the elective nodes. CRT was sequentially delivered with 45 Gy to the pelvic target and a boost of 14.4 Gy to the primary tumor.RESULTS: Median age of patients was 65 yrs for RA (59 yrs for CRT); 90% had Stage II-III (93% in the CRT group). No statistically significant differences were observed concerning survival or control. 5 yrs disease specific survival was 85.7% and 81.2%, loco-regional control was of 78.1% and 82.1% for RA and CRT respectively. RA treatments lead to lower incidence of higher grade of toxicity events (all retrospectively retrieved from charts as worse events). Grade 2-3 toxicity, compared to CRT, reduced from 89% to 68% for GI, from 39% to 33% for GU and from 82% to 75% for the skin. Late toxicity was as follows: 5/36 (14%) and 3/36 (8%) patients had G1 or G2 GI toxicity in the RA group (1/28 (4%) and 4/28 (14%) in the CRT group). GU late toxicity was observed only in 4/28 (14%) patients of the CRT group: 3/28 (11%) had G2 and 1/28 (4%) had G1.CONCLUSIONS: RA treatments of ACC patients proved to be equally effective than CRT but it was associated to a reduction of toxicity.

AB - BACKGROUND: To appraise the role of volumetric modulated arc (RapidArc, RA) in the treatment of anal canal carcinoma (ACC).METHODS: A retrospective analysis has been conducted on 36 patients treated with RA since 2009 comparing outcome against a group of 28 patients treated with conformal therapy (CRT). RA treatments were prescribed with SIB technique with 59.4 Gy to the primary tumor and nodes and 49.5 Gy to the elective nodes. CRT was sequentially delivered with 45 Gy to the pelvic target and a boost of 14.4 Gy to the primary tumor.RESULTS: Median age of patients was 65 yrs for RA (59 yrs for CRT); 90% had Stage II-III (93% in the CRT group). No statistically significant differences were observed concerning survival or control. 5 yrs disease specific survival was 85.7% and 81.2%, loco-regional control was of 78.1% and 82.1% for RA and CRT respectively. RA treatments lead to lower incidence of higher grade of toxicity events (all retrospectively retrieved from charts as worse events). Grade 2-3 toxicity, compared to CRT, reduced from 89% to 68% for GI, from 39% to 33% for GU and from 82% to 75% for the skin. Late toxicity was as follows: 5/36 (14%) and 3/36 (8%) patients had G1 or G2 GI toxicity in the RA group (1/28 (4%) and 4/28 (14%) in the CRT group). GU late toxicity was observed only in 4/28 (14%) patients of the CRT group: 3/28 (11%) had G2 and 1/28 (4%) had G1.CONCLUSIONS: RA treatments of ACC patients proved to be equally effective than CRT but it was associated to a reduction of toxicity.

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U2 - 10.1186/1471-2407-14-833

DO - 10.1186/1471-2407-14-833

M3 - Article

C2 - 25403766

AN - SCOPUS:84936743126

VL - 14

SP - 833

JO - BMC Cancer

JF - BMC Cancer

SN - 1471-2407

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