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

Luciana Caravatta, Giovanna Mantello, Francesca Valvo, Pierfrancesco Franco, Lucrezia Gasparini, Consuelo Rosa, Najla Slim, Stefania Manfrida, Francesca De Felice, Marianna A Gerardi, Stefano Vagge, Marco Krengli, Elisa Palazzari, Maria Falchetto Osti, Alessandra Gonnelli, Gianpiero Catalano, Patrizia Pittoni, Giovani Battista Ivaldi, Alessandra Galardi, Marco LupattelliMaria Elena Rosetto, Rita Marina Niespolo, Alessandra Guido, Oreste Durante, Gabriella Macchia, Fernando Munoz, Badr El Khouzai, Maria Rosaria Lucido, Annamaria Porreca, Marta Di Nicola, Maria Antonietta Gambacorta, Vittorio Donato, Domenico Genovesi

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Abstract

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.

Original languageEnglish
Article number1902
Number of pages18
JournalCancers
Volume13
Issue number8
DOIs
Publication statusPublished - Apr 15 2021

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