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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 11/2015

01-11-2015 | Original Article

Volumetric intensity-modulated arc therapy vs. 3-dimensional conformal radiotherapy for primary chemoradiotherapy of anal carcinoma

Effects on treatment-related side effects and survival

Authors: Dr. med. Hanne Elisabeth Weber, M.D., Dr. med. Leif Hendrik Dröge, M.D., Dr. med. Steffen Hennies, M.D., Dr. med. Markus Karl Herrmann, M.D., PD Dr. med. Jochen Gaedcke, M.D., PD Dr. med. Hendrik Andreas Wolff, M.D.

Published in: Strahlentherapie und Onkologie | Issue 11/2015

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Abstract

Background

Primary chemoradiotherapy (CRT) is the standard treatment for locally advanced anal carcinoma. This study compared volumetric intensity-modulated arc therapy (VMAT) to 3-dimensional conformal radiotherapy (3DCRT) in terms of treatment-related side effects and survival.

Patients and methods

From 1992–2014, 103 consecutive patients with anal carcinoma UICC stage I–III were treated. Concomitant CRT consisted of whole pelvic irradiation, including the iliac and inguinal lymph nodes, with 50.4 Gy (1.8 Gy per fractions) by VMAT (n = 17) or 3DCRT (n = 86) as well as two cycles of 5-fluorouracil and mitomycin C. Acute organ and hematological toxicity were assessed according to the Common Terminology Criteria (CTC) for Adverse Events version 3.0. Side effects ≥ grade 3 were scored as high-grade toxicity.

Results

High-grade acute organ toxicity CTC ≥ 3 (P < 0.05), especially proctitis (P = 0.03), was significantly reduced in VMAT patients. The 2-year locoregional control (LRC) and disease-free survival (DFS) were both 100 % for VMAT patients compared with 80 and 73 % for 3DCRT patients.

Conclusion

VMAT was shown to be a feasible technique, achieving significantly lower rates of acute organ toxicity and promising results for LRC and DFS. Future investigations will aim at assessing the advantages of VMAT with respect to late toxicity and survival after a prolonged follow-up time.
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Metadata
Title
Volumetric intensity-modulated arc therapy vs. 3-dimensional conformal radiotherapy for primary chemoradiotherapy of anal carcinoma
Effects on treatment-related side effects and survival
Authors
Dr. med. Hanne Elisabeth Weber, M.D.
Dr. med. Leif Hendrik Dröge, M.D.
Dr. med. Steffen Hennies, M.D.
Dr. med. Markus Karl Herrmann, M.D.
PD Dr. med. Jochen Gaedcke, M.D.
PD Dr. med. Hendrik Andreas Wolff, M.D.
Publication date
01-11-2015
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 11/2015
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-015-0859-6

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