Treatment of anal carcinoma in the elderly

Allal, Abdelkarim Said; Obradović, M.; Laurencet, F; Roth, Arnaud; Spada, Alessandra; Marti, M.-C.; Kurtz, John M.

doi:10.1002/(sici)1097-0142(19990101)85:1<26::aid-cncr4>3.0.co;2-0

Cited by 39 publications

(2 citation statements)

References 29 publications

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“…We are unable to determine if this was related to toxic effects of treatment or if clinicians planned to deliver lower doses and omit chemotherapy for these patients; because elderly and more comorbid patients did not have higher rates of treatment interruption, we hypothesize the latter is the more likely reason. Although there are conflicting reports as to how older adults tolerate chemoradiation treatment for SCCA, [19][20][21][22][23] and some studies have suggested omission of chemotherapy or reduction in radiation dose/volume might be appropriate, 24,25 guidelines still recommended that older adults be treated similarly to their younger counterparts. 3,4 Therefore, the results of this study highlight the need for audits and quality improvement efforts to ensure that older adults are receiving guidelineconcordant treatment.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Chemoradiation Therapy Interruption and Noncompletion Among Patients With Squamous Cell Anal Carcinoma

Raphael

Booth

et al. 2020

JAMA Oncol

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IMPORTANCE Definitive chemoradiation for anal cancer is effective but may be associated with toxic effects, and some patients may not be able to complete the planned treatment. Identifying factors associated with treatment interruption and noncompletion is important to target quality improvement efforts. OBJECTIVE To identify rates of chemoradiation treatment interruption or noncompletion and factors associated with this among patients with anal cancer treated in routine clinical practice. DESIGN, SETTING, AND PARTICIPANTSIn this population-based, retrospective cohort study, the Ontario Cancer Registry was used to identify all incident cases of squamous cell anal cancer treated with curative-intent radiation from 2007 to 2015 in Ontario, Canada. Final analysis of data was performed on August 9, 2019.EXPOSURES Curative-intent radiation therapy. MAIN OUTCOMES AND MEASURESTreatment interruption was defined as more than 7 days between fractions of radiation. Radiation completion was defined as receipt of 45 Gy or more and 25 fractions of radiation. Chemoradiation completion was defined as radiation completion and 2 doses of combination chemotherapy. Associations between patient factors and treatment interruption and noncompletion were estimated with log-binomial models. Cox proportional hazard models were used to estimate the association of treatment interruption or noncompletion with all-cause death, cancer-specific death, and the combined outcome of colostomy or death. RESULTSOverall, 1125 patients with stage I-III anal cancer were treated with curative-intent radiation. Treatment interruptions occurred in 262 (23%). Radiation and chemoradiation noncompletion occurred in 199 (18%) and 280 (25%), respectively. No associations were found to correlate with an increased risk of treatment interruption. Patients older than 70 years were less likely to complete chemoradiation (risk ratio [RR], 0.60; 95% CI, 0.52-0.70), compared with those younger than 50 years. Patients with a higher number of comorbidities were also less likely to complete chemoradiation (RR, 0.70; 95% CI, 0.51-0.95). Patients who did not complete chemoradiation had a higher risk of requiring salvage abdominoperineal resection (

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Section: Discussionmentioning

confidence: 99%

Factors Associated With Chemoradiation Therapy Interruption and Noncompletion Among Patients With Squamous Cell Anal Carcinoma

Raphael

Booth

et al. 2020

JAMA Oncol

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“…Like colorectal cancer, elderly patients were less likely received aggressive therapy for their comorbidities and poor performance state. Some studies suggested standard treatment showed a good efficacy in elderly patients with anal cancer [ 23 - 25 ].…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Survival of Korean Anal Cancer From the Korea Central Cancer Registry Data

Park¹,

Jung

Kim

et al. 2013

Ann Coloproctol

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PurposeIn Korea, anal cancer is rare disease entity with specific clinical characteristics. Therefore, no survival analysis with a sufficient patient population has been performed. The aim of this study was to evaluate the characteristics of Korean anal cancer, focusing on the survival according to tumor histologies, sex, and a specific age group, using the nationwide cancer registry.MethodsUsing the Korea Central Cancer Registry, we analyzed a total of 2,552 cases from 1993 to 2010. We assessed the 5-year relative survival by using tumor histology. In addition, survival differences of Surveillance Epidemiology and End Results (SEER) stage were analyzed for both sexes and for young-age cancer (younger than 40 years) and advanced-age cancer (older than 70 years).ResultsThe 5-year relative survival among anal cancer patients increased from 38.9% for the period 1993-1995 to 65.6% for the period 2006-2010. The anal squamous cell carcinoma was the most common histology and showed better survival than other types of cancer. Females demonstrated better survival than males in all SEER stages. The 5-year survivals for patients in whom anal cancer developed before the age of 40 and at or after the age of 40 were 62.4% and 51.6%, respectively. The 5-year survival for patients in whom cancer developed at or after the age of 70 was much worse than that for patients in whom the cancer had developed prior to that age.ConclusionKorean anal cancer has certain distinctive characteristics of survival according to tumor histology, sex, and age. Despite limitations on available data, this study used the nationwide database to provide important information on the survival of Korean patients with anal cancer.

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Feasibility and early results of accelerated radiotherapy for head and neck carcinoma in the elderly

Allal

Maire

Becker

et al. 2000

Cancer

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BACKGROUND. Accelerated radiotherapy (RT) represents a promising method with which to improve the treatment outcome in patients with head and neck carcinoma. However, its applicability to elderly patients has not been well established. This study assessed treatment toxicities, patient compliance, and oncologic results in patients age Ն 70 years who were treated with an accelerated concomitant boost RT schedule. METHODS. Between 1991 and 1997, 39 patients aged Ն 70 years (mean, 75 Ϯ 6 years) presenting with carcinomas of the oral cavity, pharynx, or larynx were treated radically with a modified concomitant boost RT schedule (planned dose of 69.9 grays [Gy] over 38 days). Based on American Joint Committee on Cancer staging, there were 14 patients with Stage I-II disease and 25 patients with Stage III-IV disease. Eighty-one patients age Ͻ 70 years who were treated with the same RT schedule served as a comparative group. The median follow-up for the surviving patients was 19 months (range, 3-65 months) and 23 months (range, 2-76 months), respectively, for the elderly and younger patient groups.

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Treatment of anal carcinoma in the elderly

Cited by 39 publications

References 29 publications

Factors Associated With Chemoradiation Therapy Interruption and Noncompletion Among Patients With Squamous Cell Anal Carcinoma

Factors Associated With Chemoradiation Therapy Interruption and Noncompletion Among Patients With Squamous Cell Anal Carcinoma

Characteristics and Survival of Korean Anal Cancer From the Korea Central Cancer Registry Data

Feasibility and early results of accelerated radiotherapy for head and neck carcinoma in the elderly

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