Anal cancer treated with radio-chemotherapy: correlation between length of treatment interruption and outcome

Eissen, J. Meier zu; Kolbert, G.; Bremer, Michael; Karstens, Johann H.; Meyer, Andreas

doi:10.1007/s00384-009-0775-2

Cited by 9 publications

(3 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Out of 130 papers, 116 papers reported all adverse events (regardless of grade), 14 papers reported only adverse events Grade 3 or above. The incidence of Grade 1 and 2 toxicities were 26.4-50%, whilst that of Grade 3 and above were reported to occur between 0 and 33.3% of patients [4,[20][21][22][23][24][25][26]. Eighteen papers reported only the incidence of overall GI adverse events with no data for individual GI symptom [4,[27][28][29][30].…”

Section: Overviewmentioning

confidence: 99%

Late gastrointestinal toxicity after radiotherapy for anal cancer: a systematic literature review

et al. 2018

View full text Add to dashboard Cite

Introduction: There is a paucity of data on incidence and mechanisms of long-term gastrointestinal consequences after chemoradiotherapy for anal cancer. Most of the adverse effects reported were based on traditional external beam radiotherapy whilst only short-term follow-ups have been available for intensity-modulated radiotherapy, and there is lack of knowledge about consequences of doseescalation radiotherapy. Method: A systematic literature review. Results: Two thousand nine hundred and eighty-five titles (excluding duplicates) were identified through the search; 130 articles were included in this review. The overall incidence of late gastrointestinal toxicity was reported to be 7-64.5%, with Grade 3 and above (classified as severe) up to 33.3%. The most commonly reported late toxicities were fecal incontinence (up to 44%), diarrhea (up to 26.7%), and ulceration (up to 22.6%). Diarrhea, fecal incontinence and buttock pain were associated with lower scores in radiotherapy specific quality of life scales (QLQ-CR29, QLQ-C30, and QLQ-CR38) compared to healthy controls. Intensity-modulated radiation therapy appears to reduce late toxicity. Conclusion: Late gastrointestinal toxicities are common with severe toxicity seen in one-third of the patients. These symptoms significantly impact on patients' quality of life. Prospective studies with control groups are needed to elucidate long-term toxicity.

show abstract

Section: Overviewmentioning

confidence: 99%

Late gastrointestinal toxicity after radiotherapy for anal cancer: a systematic literature review

et al. 2018

View full text Add to dashboard Cite

show abstract

“…84,85,86 However, a retrospective analysis of 101 patients treated with http://www.sajo.org.za Open Access chemoradiation demonstrated that a 5-year local control and colostomy-free survival rates were not adversely affected when treatment was interrupted by more than six cumulative treatment days, compared to six or less. 87…”

Section: Anus Overall Treatment Timementioning

confidence: 99%

Estimation of the effects of radiotherapy treatment delays on tumour responses: A review

Hunter

Hendrikse

2020

South African Journal of Oncology

View full text Add to dashboard Cite

Background:The effects of radiotherapy treatment delays vary considerably depending on several factors, including tumour type, tumour characteristics, extent of delay and the radiation schedule. Both delays during treatment and delays in starting treatment may have an impact on tumour outcomes. In developing countries, particularly, budget constraints and overwhelming patient numbers may contribute to long waiting lists that may affect treatment efficacy. Empirical evidence on which to base treatment decisions and to motivate for additional resources is important. Aim:The aim of this study was to review the evidence that radiotherapy treatment delays may affect tumour response in several common tumour types and to determine, where reported, estimates of specific, commonly applied parameters to incorporate time and proliferation.Setting: Clinical radiotherapy of solid tumours.Methods: A review of the literature from an online database and search engine using terms associated with treatment delays or interruptions for a range of common tumour types was conducted.Results: There is evidence in several of the tumour types reviewed, including those of the head and neck, breast, cervix, prostate, lung, colorectal, anus, brain and bladder, that delays in radiotherapy can affect treatment outcomes. While, in most cases, delays in treatment are detrimental, there are certain examples cited where delays between other modalities and radiotherapy may be beneficial. Conclusion:While levels of evidence vary, failure to take note of proliferative effects of tumours because of extensions in treatment may in many cases result in avoidable treatment failures. It is thus prudent for radiation oncology departments to have clear policies for avoiding and dealing with treatment delays.

show abstract

“…As results matured and further insight in tumor radiobiology was gained, this long treatment gap was considered to be potentially hazardous, due to the likelihood of tumor repopulation during the treatment gap. In the subsequent studies, the treatment gap was shortened to 2 weeks, which not only seemed to be feasible, but also resulted in better LRC in some studies [36][37][38][39][40] but not in others [41,42]. With the advent of IMRT and VMAT, the entire radiation course could be administered without a treatment break.…”

Section: The Treatment Gapmentioning

confidence: 99%

Evolving Concepts toward Individualized Treatment of Squamous Cell Carcinoma of the Anus

Dewit¹,

Cats²,

Beets³

2020

Squamous Cell Carcinoma - Hallmark and Treatment Modalities

View full text Add to dashboard Cite

Treatment of squamous cell carcinoma of the anus has evolved over the last 5 decades from radical surgery to combined chemoradiation therapy. Radiation treatment techniques have dramatically improved with the development of more powerful computers, algorithms and treatment machines. The clinical impact of the modern radiation treatment techniques, such as intensity-modulated radiotherapy and volumetric modulated arc therapy, is discussed. The standard-of-care regimen still is concurrent Mitomycin C, 5-fluorouracil and high-dose radiation, as was conceived 45 years ago. Variants of this schedule are discussed in this chapter. International guidelines have been generated and implemented. Whereas concurrent chemoradiation therapy is the treatment of choice for locally advanced tumors, early tumors are probably adequately controlled with either reduced dose chemoradiation therapy or radiation therapy alone. Prognostic factors, such as high-risk human papillomavirus, epidermal growth factor receptor and immune response, will be highlighted. The role of surgery in primary care is limited to local excision of T1N0 tumors ≤ 1 cm of the anal margin. Salvage radical surgery is limited to locoregional recurrent, non-metastasized and resectable tumors after chemoradiation therapy. In addition, new treatment modalities, such as targeted therapy and immunotherapy, will be discussed. Current research aims at refining prognostic subgroups to further individualize treatment strategy, implementing quality assurance protocols in international trials and investigating the molecular profile of squamous cell carcinoma of the anus, in order to identify new treatment avenues. This will hopefully change the landscape of anal cancer treatment in the future.

show abstract

Anal cancer treated with radio-chemotherapy: correlation between length of treatment interruption and outcome

Abstract: Definitive radio-chemotherapy with short individualised treatment interruption shows high local control and colostomy-free survival rates.

Cited by 9 publications

References 29 publications

Late gastrointestinal toxicity after radiotherapy for anal cancer: a systematic literature review

Late gastrointestinal toxicity after radiotherapy for anal cancer: a systematic literature review

Estimation of the effects of radiotherapy treatment delays on tumour responses: A review

Evolving Concepts toward Individualized Treatment of Squamous Cell Carcinoma of the Anus

Contact Info

Product

Resources

About