Patterns and predictors of relapse following radical chemoradiotherapy delivered using intensity-modulated radiotherapy with a simultaneous integrated boost in anal squamous cell carcinoma

Shakir, Rebecca; Adams, Richard; Cooper, R.; Downing, Amy; Geh, Ian; Gilbert, Duncan C.; Jacobs, C.; Jones, C.; Lorimer, C.; Namelo, Wanangwa C.; Sebag‐Montefiore, David; Shaw, Paul; Muirhead, R.

doi:10.1093/annonc/mdz155.158

Cited by 2 publications

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“…One of the limitations of this study was the small number of relapses in ASCC. This reflects the excellent outcomes with the UK IMRT guidance (31). We chose to scan only once during CRT as we envisage DW-MRI as an early prognostic factor to enable change in management plan in a subset of patients.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study of Diffusion-weighted Magnetic Resonance Imaging as an Early Prognostic Biomarker in Chemoradiotherapy in Squamous Cell Carcinomas of the Anus

et al. 2020

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The use of diffusion-weighted magnetic resonance imaging as a prognostic marker of treatment response would enable early individualisation of treatment. We aimed to quantify the changes in mean apparent-diffusion-coefficient (∆ADC Mean ) between a DW-MRI at diagnosis and on fraction 8-10 of chemoradiotherapy (CRT) as a biomarker for cellularity, and correlate these with ASCC recurrence. Methods and materialsThis prospective study recruited patients with localised anal cancer between October 2014 and November 2017. DW-MRI was performed at diagnosis and after fraction 8-10 of radical CRT. A region of interest (ROI) was delineated for all primary tumours and any lymph nodes >2 cm on highresolution T 2 -weighted images and propagated to the ADC map. Routine clinical follow up was collected from NHS electronic systems. ResultsTwenty-three of 29 recruited patients underwent paired DW-MRI scans. 26 ROIs were delineated among the 23 evaluable patients. The median (range) tumour volume was 13.6 cm 3 (2.8 cm 3 to 84.9 cm 3 ). Ten of 23 patients had lesions with ∆ADC Mean ≤20%. With a median follow-up of 41.2 months, 4 patients either failed to have a complete response to CRT, or subsequently relapsed. Three of 4 patients with disease relapse had lesions demonstrating ∆ADC Mean ≤20%, the other patient with persistent disease had ∆ADC Mean of 20.3%. ConclusionsWe demonstrated a potential correlation between patients with ∆ADC Mean ≤20% and disease relapse.Further investigation of the prognostic merit of DW-MRI change is needed in larger, prospective cohorts.

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Section: Discussionmentioning

confidence: 99%

A Prospective Study of Diffusion-weighted Magnetic Resonance Imaging as an Early Prognostic Biomarker in Chemoradiotherapy in Squamous Cell Carcinomas of the Anus

et al. 2020

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“…Factors that are widely known to affect survival are tumor size, nodal metastasis and sex [5]. Additionally, as etiology of anal cancer is closely related with human papilloma virus (HPV) or human immunodeficiency virus (HIV) infection, immunologic factors such as p16 expression, leukocytopenia, neutropenia, and lymphocytosis have been related with improved survival [6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Bulky Nodal Disease in Anal Cancer Management: A Multi-institutional Study

Chun,

Kim,

Jang

et al. 2024

Cancer Res Treat

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This study aimed to assess the prognostic significance of bulky nodal involvement in patients with anal squamous cell carcinoma treated with definitive chemoradiotherapy. Materials and MethodsWe retrospectively analyzed medical records of patients diagnosed with anal squamous cell carcinoma who underwent definitive chemoradiotherapy at three medical centers between 2004 and 2021. Exclusion criteria included distant metastasis at diagnosis, 2D radiotherapy, and salvage treatment for local relapse. Bulky N+ was defined as nodes with a long diameter of 2 cm or greater. ResultsA total of 104 patients were included, comprising 51 with N0, 46 with non-bulky N+, and 7 with bulky N+. The median follow-up duration was 54.0 months (range, 6.4-162.2 months). Estimated 5-year progression-free survival (PFS), loco-regional recurrence-free survival (LRRFS), and overall survival (OS) rates for patients with bulky N+ were 42.9%, 42.9%, and 47.6%, respectively.Bulky N+ was significantly associated with inferior PFS, LRRFS and OS compared to patients without or with non-bulky N+, even after multivariate analysis. We proposed a new staging system incorporating bulky N+ as N2 stage, with estimated 5-year LRRFS, PFS, and OS rates of 81.1%, 80.6%, and 86.2% for stage I, 67.7%, 60.9%, and 93.3% for stage II, and 42.9%, 42.9%, and 47.6% for stage III disease, enhancing the predictability of prognosis. ConclusionPatients with bulky nodal disease treated with standard chemoradiotherapy experienced poor survival outcomes, indicating the potential necessity for further treatment intensification.

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Patterns and predictors of relapse following radical chemoradiotherapy delivered using intensity-modulated radiotherapy with a simultaneous integrated boost in anal squamous cell carcinoma

Cited by 2 publications

References 0 publications

A Prospective Study of Diffusion-weighted Magnetic Resonance Imaging as an Early Prognostic Biomarker in Chemoradiotherapy in Squamous Cell Carcinomas of the Anus

A Prospective Study of Diffusion-weighted Magnetic Resonance Imaging as an Early Prognostic Biomarker in Chemoradiotherapy in Squamous Cell Carcinomas of the Anus

Prognostic Significance of Bulky Nodal Disease in Anal Cancer Management: A Multi-institutional Study

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