The use of radiation therapy combined with chemotherapy in the management of squamous cell carcinoma of the anus and marginally resectable adenocarcinoma of the rectum

Sischy, Ben

doi:10.1016/0360-3016(85)90210-x

Cited by 133 publications

(24 citation statements)

References 16 publications

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“…After a lot of series with different chemotherapies, 5FU and Mitomycine C (Sischy, 1985;Cummings et al, 1991), 5FU and Cisplatine (Rich et al, 1993;Doci et al, 1996), Bleomycine (Friberg et al, 1998), two articles reporting on randomised trials showed the advantages of the 5FU/Mitomycine C combination treatment in terms of local control and colostomy-free interval (UKCCCR, 1996;Bartelink et al, 1997). In the first series, however, this treatment was only delivered to T3/T4 and N þ patients.…”

Section: Discussionmentioning

confidence: 99%

Anal canal cancer treatment: practical limitations of routine prescription of concurrent chemotherapy and radiotherapy

et al. 2003

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This study is an analysis of the criteria considered when prescribing concomitant chemotherapy and radiotherapy, as a routine treatment for patients with anal canal cancer, and related complications. Between 1990 and 1996, 67 patients were treated at Institut Curie for invasive, nonmetastatic cancer of the anal canal. Median age was 65 years (range, 35 -90 years). TNM stage distribution was as follows: seven T1, 17 T2, 27 T3, 16 T4, and 22 N þ patients. A total of 29 patients (i.e., five T1/T2, and 24 T3/T4) received concurrent chemotherapy and radiotherapy. Radiotherapy volumes and dose and prescribed dose for chemotherapy were not statistically different from one group of patients to another. Only 55% of T3/T4 patients underwent standard chemoradiation treatment for anal canal cancer. Age was the one of main factor in determining if the patient would undergo concomitant chemotherapy or not. For the T3/T4 patients, concomitant chemotherapy was prescribed to 69% of patients o55 years, 90% of patients between 56 and 64 years, 45% of patients between 65 and 75 years, and 20% of patients over 75 years (Po0.02).Overall survival at 4 years was 66%. The 4 years overall survival rate of T3/T4 patients, who underwent concomitant chemotherapy, was 72%, and that of T3/T4 patient who did not, was 34% (Po0.04). The patients who did not undergo chemotherapy were significantly older. The difference in cause-specific survival rates (72 vs 48%) was not significant. Relapse-free interval without local recurrence at 4 years was 70%. Relapse-free interval of T3/T4 patients was 78% with chemotherapy and 60% without chemotherapy (p ¼ NS). Rates of treatment discontinuation and early toxicity were not statistically different. Late complications occurred in 33 patients, eight of whom had grade 2/3 tumours. At 2 years, complications occurred in 39% of patients who had undergone concomitant chemotherapy, and in 20% of patients who had not (po0.02). Differences in grade 2/3 complications were not significant. In conclusion, although radiotherapy with concomitant chemotherapy is considered the current 'gold-standard' treatment for anal canal cancer, in our daily experience, only 55% of our T3/T4 patients have undergone this treatment. The remainder did not undergo chemotherapy mainly because they were deemed too old. In this series, no increase in local control and cause-specific survival was observed in patients who received concomitant chemotherapy; this may be due to the small number of patients included in the series. The increased rate of late complications observed in patients who received the combined treatment, however, provides evidence that this treatment should be restricted to younger patients without comorbidity and therefore justifies our position. Perhaps reduction of doses of chemotherapy must be discussed for older patients.

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Section: Discussionmentioning

confidence: 99%

Anal canal cancer treatment: practical limitations of routine prescription of concurrent chemotherapy and radiotherapy

et al. 2003

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“…This led to the concept of definitive radiation therapy combined with chemotherapy [46]. There are now multiple published clinical series on combined chemoradiation (Table 2) [47][48][49][50][51][52]. Most reported studies have utilized a treatment regimen similar to the original Nigro protocol that combined radiation treatment with 5-fluorouracil (5-FU) and mitomycin.…”

Section: Combined Modality Treatment Retrospective Data On Combined Cmentioning

confidence: 99%

“…Most reported studies have utilized a treatment regimen similar to the original Nigro protocol that combined radiation treatment with 5-fluorouracil (5-FU) and mitomycin. However, the radiation dose delivered was moving from Nigro's 30 Gy [55] towards [45][46][47][48][49][50]57,58].…”

Section: Combined Modality Treatment Retrospective Data On Combined Cmentioning

confidence: 99%

Carcinoma of the Anus: Strategies in Management

2002

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The management of anal cancer underwent an interesting transformation over the last two decades. Prior to this period, the standard definitive treatment for carcinoma of the anal canal was abdominal-perineal resection, which necessitated a permanent colostomy. The organ preservation concept appeared following the discovery of a high complete response rate from preoperative combined chemoradiation prior to abdominal-perineal resection.The organ preservation method of treatment rapidly gained popularity and ultimately saved a large number of patients from undergoing abdominal-perineal resection and colostomy. Chemoradiation treatment itself subsequently went through an evolutionary process. Several studies have sought to define the optimal chemotherapeutic regimen as well as radiation treatment dose and fractionation. Ongoing studies attempt to define an optimal treatment regimen that yields a higher cure rate while minimizing toxicity. We review the etiology, epidemiology, and treatment regimens for anal cancer.

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“…Associada à quimioterapia, realiza-se a radioterapia com dose de radiação entre 4500 e 5500cGy, dividida em 5 semanas (20,30,31,32) . Nos estádios iniciais, menores doses de radiação (3000cGy) têm bons resultados com menos efeitos colaterais (34,35) . Com esta terapêutica, observa-se índice de sobrevida de 70%, após 5 anos.…”

Section: Discussionunclassified

Carcinoma espinocelular de canal anal: análise de 11 casos

Guimarães

Matos

Segreto

et al. 2001

Arq. Gastroenterol.

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RESUMO INTRODUÇÃOO câncer de canal anal apresenta-se como um tipo infreqüente de neoplasia. Nos EUA observa-se que cerca de 1% a 2% dos cânceres de intestino grosso e 3,9% dos tumores anorretais são de canal anal (16,33) . O tipo histológico mais comum é o espinocelular, observado em até 47% dos casos, seguido pelos tipos, cloacogênico, adenocarcinoma e, mais raramente, melanoma ou adenocarcinoma mucinoso (33)

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The use of radiation therapy combined with chemotherapy in the management of squamous cell carcinoma of the anus and marginally resectable adenocarcinoma of the rectum

Cited by 133 publications

References 16 publications

Anal canal cancer treatment: practical limitations of routine prescription of concurrent chemotherapy and radiotherapy

Anal canal cancer treatment: practical limitations of routine prescription of concurrent chemotherapy and radiotherapy

Carcinoma of the Anus: Strategies in Management

Carcinoma espinocelular de canal anal: análise de 11 casos

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