Anal Canal Cancer: Management of Inguinal Nodes and Benefit of Prophylactic Inguinal Irradiation (CORS-03 Study)

Evaluation of a 36 Gy elective node irradiation dose in anal cancer

“…It was 7.8% in the large retrospective analysis by Gerard et al in patients without PII [22]. In a Nordic cohort, it was 2.4% after a PII dose of 45-50 Gy [23], and in a series reported by Ortholan et al, the 5-year actuarial inguinal recurrence rate was 2% after a PII dose of 45-50 Gy, while the rates in T3-T4 and T1-T2 tumors without PII were 30% and 12%, respectively [24]. Therefore, PII should be recommended for all disease stages [23,25,26].…”

Cancers of the Anal Canal: Diagnosis, Treatment and Future Strategies

“…Prophylactic irradiation of negative inguinal lymph nodes can reduce the incidence of inguinal lymph node recurrence [79]. Metachronous lymph node metastases have been shown to occur in up to 25% of patients without positive inguinal nodes at the time of primary treatment, compared with 2-5% of those patients with initially node-negative disease who received prophylactic irradiation [75,79].…”

Chemoradiotherapy for anal cancer: clinical trials past, present and future

“…Ortholon et al retrospectively analyzed the outcome of 208 patients presenting with anal canal squamous cancer in four cancer centers in France [33]. The aim of the study was to specifically look at the relapse rate in irradiated and nonirradiated inguinal nodes.…”

“…Subsequent single-center studies have reported the possibility of reducing the dose for patients with low-risk disease (T1N0) [33,[46][47]. Therefore, an option would be to treat patients with early-stage disease with both a reduced volume and reduced dose resulting in maintained good outcomes, but a reduction in long-term toxicity.…”