A comparison between 5-fluorouracil/mitomycin and capecitabine/mitomycin in combination with radiation for anal cancer

Peixoto, Renata D’Alpino; Wan, Dante; Schellenberg, Devin; Lim, Howard John

doi:10.21037/jgo.2016.06.04

Cited by 24 publications

(12 citation statements)

References 31 publications

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“…Analysing the other protocols employed, 5% received the Mayo protocol, with the difference ( 5 OS: 55% versus 71%, p = 0.06) in favour of Nigro, and 4% received an alternative protocol, Capecitabine/MMC, with results showing slight benefit to the alternative protocol ( 5 OS: 91% versus 75%, p = 0.58), with no statistically significant difference in concordance with different authors based on non-inferior results, such as alternative therapies in patients who were not candidates for Nigro [23,29,43,44] for medical reasons, co-morbidities or lack of availability of infusion pumps to administer the Nigro protocol.…”

Section: Discussionmentioning

confidence: 79%

Cancer of the anal canal, a reality in the Colombian coffee region. Clinical-epidemiological review 2000–2019

Mejia¹,

Jaramillo

2021

ecancer

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Introduction: Anal cancer is a rare pathology which has increased over the last few decades, and, therefore, gained importance for the quality of life of affected individuals. Thus, a review has been conducted in the Colombian coffee region (Departments of Caldas, Quindío y Risaralda) describing its behaviour and clinical-epidemiological profile. Materials and methods: Descriptive review of 437 patients of Western SAS Oncologists between January 2000 and December 2019 with a diagnosis of anal cancer. Results: 62% of cases presented in women with a median age of 62 years, 30% in the sixth decade; centred at 65% in three main cities designated as capitals (Manizales, Pereira and Armenia); 62% as localised disease, with 40% stage II-A and 6% as initial metastasis; 29% presented positive ganglia, particularly N1a; squamous cell or epidermoid histology in 90%; 16% poorly differentiated; 5% related to Human Immunodeficiency Virus infection; localisation in the medial area of the anal canal in 63% of cases; 83% completed treatment, and 92% of them received chemotherapy/radiation therapy with 87% based on the Nigro protocol; finally, 11% presented with relapse in the liver in 10% of cases and 55% local. Conclusion: Four hundred and thirty-seven patients evaluated over 20 years with follow up at median 34.13 months (standard deviation 41.75) with median survival at later ages decreasing to 62% in patients older than 80 years, and differences in survival in localised disease at 78% in comparison to 46% in advanced metastasis. Finally, the overall 5-year survival rate is 69% with a median survival of 191 months in the study.

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Section: Discussionmentioning

confidence: 79%

Cancer of the anal canal, a reality in the Colombian coffee region. Clinical-epidemiological review 2000–2019

Mejia¹,

Jaramillo

2021

ecancer

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“…from 2 studies [51,52]]. With respect to further outcomes reported in this summary, no significant differences were seen: CSS [Peixoto et al [53] did not find a significant difference; data not meta-analysed due to reporting issues], DFS [HR 1.13 (0.65-1.95), GRADE: ⨁◯◯◯, 300 pts. from 1 study [53]], CFS [HR 0.66 (0.28-1.54), GRADE: ⨁◯◯◯, 300 pts.…”

Section: Number Of Hits and Included Studiesmentioning

confidence: 80%

“…We identified four comparative cohort studies [50][51][52][53] in which a chemoradiation regimen with MMC and 5-FU was compared to chemoradiation with capecitabine (CCB) and 5-FU in patients with stage I-III anal cancer. These studies included one prospective cohort study [51] (serious risk of bias), and three retrospective cohort studies (two of these [50,52] rated as being at moderate and one [53] rated as being at serious risk of bias). Both interventions were roughly equivalent (i.e., had a narrow confidence interval around the line of no effect) with respect to OS [RR 0.98 (0.89-1.08) after a median follow-up of 2 years, GRADE: ⨁◯◯◯, 100 pts.…”

Section: Number Of Hits and Included Studiesmentioning

confidence: 99%

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State of the art treatment for stage I to III anal squamous cell carcinoma: A systematic review and meta-analysis

Werner

Gaskins

Valle

et al. 2021

Radiotherapy and Oncology

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“… 1 , 46 MMC has been suggested to convert unresectable patients to surgical candidates, 42 enhance the therapeutic effects of adjuvant CRT, 47 and improve local control 48 in periampullary adenocarcinoma. Although it has not been extensively studied in PDAC, MMC has been used in other cancers such as anal cancer, 49 , 50 , 51 and recent studies suggest its promising role in PDAC patients with a family history of PDAC and/or carcinomas with an inactivating mutation in a Fanconi anemia pathway gene (such as BRCA1, BRCA2 , or PALB2 ). 18 , 19 , 20 , 21 , 22 , 23 Study results from trial A demonstrated that having a family history of PDAC specifically resulted in a borderline significant improvement in OS (164.4 vs 28.7 months, P = .058).…”

Section: Discussionmentioning

confidence: 99%

Long-term analysis of 2 prospective studies that incorporate mitomycin C into an adjuvant chemoradiation regimen for pancreatic and periampullary cancers

Schunke

Rosati

Zahurak

et al. 2018

Advances in Radiation Oncology

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PurposeThe purpose of this study was to report toxicity and long-term survival outcomes of 2 prospective trials evaluating mitomycin C (MMC) with 5-fluorouracil–based adjuvant chemoradiation in resected periampullary adenocarcinoma.Methods and materialsFrom 1996 to 2002, 119 patients received an adjuvant 4-drug chemotherapy regimen of 5-fluorouracil, leucovorin, MMC, and dipyridamole with chemoradiation on 2 consecutive trials (trials A and B). Trial A patients received upfront chemoradiation (50 Gy split-course, 2.5 Gy/fraction) followed by 4 cycles of the 4-drug chemotherapy with bolus 5-fluorouracil. Trial B patients received 1 cycle of the 4-drug chemotherapy with continuous infusion 5-fluorouracil followed by continuous chemoradiation (45-54 Gy, 1.8 Gy/fraction) and 2 additional cycles of chemotherapy. Cox proportional hazards models were performed to identify prognostic factors for overall survival (OS).ResultsOf the 62 trial A patients, 61% had pancreatic and 39% nonpancreatic periampullary carcinomas. Trial B (n = 57) consisted of 68% pancreatic and 32% nonpancreatic periampullary carcinomas. Resection margin and lymph node status were similar for both trials. Median follow-up was longer for trial A than trial B (197.5 vs 107.0 months), with median OS of 32.2 and 24.2 months, respectively. Rates of 3-, 5-, and 10-year OS were 48%, 31%, and 26% in trial A and 32%, 23%, and 9% in trial B. On multivariate analysis, lymph node–positive resection was the strongest prognostic factor for OS. A pancreatic primary and positive margin status were also associated with inferior survival (P < .05). Rates of grade ≥3 treatment-related toxicity in trials A and B were 2% and 7%, respectively.ConclusionsThis is the first study to report long-term outcomes of MMC with 5-fluorouracil–based adjuvant chemoradiation in periampullary cancers. Because MMC may be considered in DNA repair-deficient carcinomas, randomized trials are needed to determine the true benefit of adjuvant MMC.

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A comparison between 5-fluorouracil/mitomycin and capecitabine/mitomycin in combination with radiation for anal cancer

Cited by 24 publications

References 31 publications

Cancer of the anal canal, a reality in the Colombian coffee region. Clinical-epidemiological review 2000–2019

Cancer of the anal canal, a reality in the Colombian coffee region. Clinical-epidemiological review 2000–2019

State of the art treatment for stage I to III anal squamous cell carcinoma: A systematic review and meta-analysis

Long-term analysis of 2 prospective studies that incorporate mitomycin C into an adjuvant chemoradiation regimen for pancreatic and periampullary cancers

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