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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 4/2020

01-04-2020 | Brachytherapy | Original Article

Intensity-modulated radiotherapy (IMRT) in the treatment of squamous cell anal canal cancer: acute and early-late toxicity, outcome, and efficacy

Authors: Veronica Dell’Acqua, Alessia Surgo, Simona Arculeo, Maria Alessia Zerella, Vincenzo Bagnardi, Samuele Frassoni, Maria Giulia Zampino, Paola Simona Ravenda, Maria Saveria Rotundo, Fatjona Kraja, Jarek Kobiela, Piotr Spychalski, Cristiana Fodor, Marianna Alessandra Gerardi, Federica Cattani, Alessia Bazani, Wanda Petz, Robert Glynne-Jones, Roberto Orecchia, Maria Cristina Leonardi, Barbara Alicja Jereczek-Fossa

Published in: International Journal of Colorectal Disease | Issue 4/2020

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Abstract

Purpose

To retrospectively review our experience on 84 patients with squamous cell anal canal cancer (SCAC) within 12 months after combined treatment with intensity-modulated RT (IMRT), in terms of acute and early-late toxicity, overall treatment time and interruptions, colostomy-free survival (CFS), and tumor response.

Methods

Acute gastrointestinal (GI), genitourinary (GU), and cutaneous (CU) toxicities were assessed according to Common Toxicity Criteria for Adverse Events (CTCAE) version 4.03. Early-late toxicity was scored using the Radiation Therapy Oncology Group (RTOG) late radiation morbidity scoring system. Tumor response was evaluated with response evaluation criteria in solid tumors (RECIST) v1.1.

Results

Acute toxicity for 84 subjects (100%): severe (≥ G3) GI and skin toxicity was observed in 4 (5%) and 19 patients (23%), respectively. Early-late toxicity for 73 subjects (87%): severe (≥ G3) GI and vulvo-vaginal toxicity was observed in 2 (3%) and 2 (3%) patients, respectively. No acute or early-late severe GU toxicity was reported. A treatment interruption occurred in 65 patients (77%). CFS was 96% (95% CI 89–99) at 6 months and 92% (95% CI 83–96) at 12 months. At 6 months complete response (CR), partial response (PR) and progressive disease (PD) was observed in 70 (83%), 3 (4%), and 7 patients (8%), respectively. At 12 months, CR was observed in 60 patients (81%); eleven patients (15%) experienced PD.

Conclusion

Our study showed an excellent clinical result and very low acute toxicity rates, confirming the IMRT as standard of care for curative treatment of anal cancer patients.
The current trial was registered with the number IEO N87/11
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Metadata
Title
Intensity-modulated radiotherapy (IMRT) in the treatment of squamous cell anal canal cancer: acute and early-late toxicity, outcome, and efficacy
Authors
Veronica Dell’Acqua
Alessia Surgo
Simona Arculeo
Maria Alessia Zerella
Vincenzo Bagnardi
Samuele Frassoni
Maria Giulia Zampino
Paola Simona Ravenda
Maria Saveria Rotundo
Fatjona Kraja
Jarek Kobiela
Piotr Spychalski
Cristiana Fodor
Marianna Alessandra Gerardi
Federica Cattani
Alessia Bazani
Wanda Petz
Robert Glynne-Jones
Roberto Orecchia
Maria Cristina Leonardi
Barbara Alicja Jereczek-Fossa
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 4/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-020-03517-x

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