Results of Curative Chemoradiotherapy in Patients with Carcinomas of the Anus

Česká verzia

Authors: J. Gombošová ¹; P. Pospíšil ¹; H. Tichá ²; P. Šlampa ¹
Authors place of work: Klinika radiační onkologie LF MU, Masarykův onkologický ústav, Brno ¹; Oddělení radiologické fyziky, Masarykův onkologický ústav, Brno ²
Published in the journal: Klin Onkol 2013; 26(3): 201-207
Category: Original Articles

Summary

Background:
Anal carcinoma is a rare cancer. Surgical treatment is applied for small superficial tumors of the anal margin, the more advanced disease is treated with concomitant chemoradiotherapy. The aim of our study was to evaluate treatment outcomes in patients treated at the Masaryk Memorial Cancer Institute in 2006– 2010.

Patients and Metods:
We reviewed the clinical data of 29 newly diagnosed adult patients (aged 40– 84, average 60.7, median 60.6 years) treated between 2006– 2010. Demographic parameters, tumor‑related variables, toxicity of treatment, overall survival were analyzed.

Results:
Acute dermal toxicity G4 was observed in two patients, G3 in nine patients. Acute intestinal toxicity G4 was not observed in any patient, G3 in four patients. Acute urologic toxicity G3– 4 was not observed in any patient. Acute hematologic toxicity was observed: leukopenia G3/ G4 in 7/ 1 patients, neutropenia G3/ 4 in 9/ 4 patients, anemia G3/ 4 in no patient and thrombocytopenia G3/ 4 in 10/ 0 patients. Severe acute toxicity G3– 4 was observed more frequently in patients treated with concurrent chemoradiotherapy. Chronic dermal toxicity G2 was observed in two patients, G1 in four patients, chronic intestinal toxicity G1 was observed in four patients. One patient had urethral stenosis and three patients had stenosis of anus without invasive solutions. One patient had osteoradionecrosis of the left pubic bone. The 5‑year overall survival of all patients was 76%. We failed to demonstrate improved survival due to the small and heterogeneous file in the group of patients in clinical stage I and II compared with patients with clinical stage III disease, or better survival in the group of patients who received concomitant chemoradiotherapy compared with patients treated only with radiotherapy.

Conclusion:
Conservative treatment of locally advanced anal cancer is relatively well tolerated and safe treatment. Efficiency is comparable to surgical therapy, is also advantageous in terms of quality of life of patients due to the sphincter preservation.

Key words:
anal carcinoma – chemoradiotherapy – radiotherapy – survival analysis

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