Intensity-modulated radiation therapy for anal cancer results from a multi-institutional retrospective cohort study

Jason A. Call, Brendan M. Prendergast, Lindsay G. Jensen, Celine B. Ord, Karyn A. Goodman, Rojymon Jacob, Loren K. Mell, Charles R. Thomas, Salma K. Jabbour, Robert C. Miller

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objectives: To assess toxicity and efficacy of intensity-modulated radiation therapy (IMRT) for anal cancer. Methods: Records of 152 patients were reviewed retrospectively from multiple institutions. Data on disease control and toxicity were collected as well as patient and treatment characteristics. Acute (< 6 mo) and late (≥6 mo) severe toxicity (grade ≥3) were graded. Four patients were excluded due to the presence of metastatic disease or stage TX. Late toxicity data were available for 120 patients. Results: Median cumulative IMRT dose was 51.25 Gy (median, 28 fractions). All but 2 patients received chemotherapy. With median follow-up of 26.8 months, local control at 3 years was 87%, worse for patients with T3-T4 than T1-T2 disease on univariate analysis (79% vs. 90%; P = 0.04). Regional control, distant control, and overall survival were 97%, 91%, and 87%, respectively, at 3 years. Nodal status was associated with regional control, distant control, and overall survival (P < 0.01 for each). Most common severe acute toxicity was hematologic (41%), skin (20%), and gastrointestinal tract (11%). Two grade 5 toxicities occurred (hematologic and gastrointestinal tract). Severe late toxicity affected skin (1%) and gastrointestinal tract (3%). Conclusions: IMRT with chemotherapy resulted in excellent local control. Although T stage predicted worse local control, most T3-T4 disease was controlled with IMRT. Nodal status predicted regional and distant control and overall survival. Severe toxicity was acceptable.

Original languageEnglish (US)
Pages (from-to)8-12
Number of pages5
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume39
Issue number1
DOIs
StatePublished - Jan 1 2016

Fingerprint

Anus Neoplasms
Cohort Studies
Radiotherapy
Retrospective Studies
Gastrointestinal Tract
Survival
Drug Therapy
Skin

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Keywords

  • Anal cancer
  • Chemoradiotherapy
  • Chemotherapy
  • Combined modality
  • Intensity-modulated radiation therapy
  • Squamous cellcarcinoma

Cite this

Call, Jason A. ; Prendergast, Brendan M. ; Jensen, Lindsay G. ; Ord, Celine B. ; Goodman, Karyn A. ; Jacob, Rojymon ; Mell, Loren K. ; Thomas, Charles R. ; Jabbour, Salma K. ; Miller, Robert C. / Intensity-modulated radiation therapy for anal cancer results from a multi-institutional retrospective cohort study. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 2016 ; Vol. 39, No. 1. pp. 8-12.
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abstract = "Objectives: To assess toxicity and efficacy of intensity-modulated radiation therapy (IMRT) for anal cancer. Methods: Records of 152 patients were reviewed retrospectively from multiple institutions. Data on disease control and toxicity were collected as well as patient and treatment characteristics. Acute (< 6 mo) and late (≥6 mo) severe toxicity (grade ≥3) were graded. Four patients were excluded due to the presence of metastatic disease or stage TX. Late toxicity data were available for 120 patients. Results: Median cumulative IMRT dose was 51.25 Gy (median, 28 fractions). All but 2 patients received chemotherapy. With median follow-up of 26.8 months, local control at 3 years was 87{\%}, worse for patients with T3-T4 than T1-T2 disease on univariate analysis (79{\%} vs. 90{\%}; P = 0.04). Regional control, distant control, and overall survival were 97{\%}, 91{\%}, and 87{\%}, respectively, at 3 years. Nodal status was associated with regional control, distant control, and overall survival (P < 0.01 for each). Most common severe acute toxicity was hematologic (41{\%}), skin (20{\%}), and gastrointestinal tract (11{\%}). Two grade 5 toxicities occurred (hematologic and gastrointestinal tract). Severe late toxicity affected skin (1{\%}) and gastrointestinal tract (3{\%}). Conclusions: IMRT with chemotherapy resulted in excellent local control. Although T stage predicted worse local control, most T3-T4 disease was controlled with IMRT. Nodal status predicted regional and distant control and overall survival. Severe toxicity was acceptable.",
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Intensity-modulated radiation therapy for anal cancer results from a multi-institutional retrospective cohort study. / Call, Jason A.; Prendergast, Brendan M.; Jensen, Lindsay G.; Ord, Celine B.; Goodman, Karyn A.; Jacob, Rojymon; Mell, Loren K.; Thomas, Charles R.; Jabbour, Salma K.; Miller, Robert C.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 39, No. 1, 01.01.2016, p. 8-12.

Research output: Contribution to journalArticle

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T1 - Intensity-modulated radiation therapy for anal cancer results from a multi-institutional retrospective cohort study

AU - Call, Jason A.

AU - Prendergast, Brendan M.

AU - Jensen, Lindsay G.

AU - Ord, Celine B.

AU - Goodman, Karyn A.

AU - Jacob, Rojymon

AU - Mell, Loren K.

AU - Thomas, Charles R.

AU - Jabbour, Salma K.

AU - Miller, Robert C.

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Y1 - 2016/1/1

N2 - Objectives: To assess toxicity and efficacy of intensity-modulated radiation therapy (IMRT) for anal cancer. Methods: Records of 152 patients were reviewed retrospectively from multiple institutions. Data on disease control and toxicity were collected as well as patient and treatment characteristics. Acute (< 6 mo) and late (≥6 mo) severe toxicity (grade ≥3) were graded. Four patients were excluded due to the presence of metastatic disease or stage TX. Late toxicity data were available for 120 patients. Results: Median cumulative IMRT dose was 51.25 Gy (median, 28 fractions). All but 2 patients received chemotherapy. With median follow-up of 26.8 months, local control at 3 years was 87%, worse for patients with T3-T4 than T1-T2 disease on univariate analysis (79% vs. 90%; P = 0.04). Regional control, distant control, and overall survival were 97%, 91%, and 87%, respectively, at 3 years. Nodal status was associated with regional control, distant control, and overall survival (P < 0.01 for each). Most common severe acute toxicity was hematologic (41%), skin (20%), and gastrointestinal tract (11%). Two grade 5 toxicities occurred (hematologic and gastrointestinal tract). Severe late toxicity affected skin (1%) and gastrointestinal tract (3%). Conclusions: IMRT with chemotherapy resulted in excellent local control. Although T stage predicted worse local control, most T3-T4 disease was controlled with IMRT. Nodal status predicted regional and distant control and overall survival. Severe toxicity was acceptable.

AB - Objectives: To assess toxicity and efficacy of intensity-modulated radiation therapy (IMRT) for anal cancer. Methods: Records of 152 patients were reviewed retrospectively from multiple institutions. Data on disease control and toxicity were collected as well as patient and treatment characteristics. Acute (< 6 mo) and late (≥6 mo) severe toxicity (grade ≥3) were graded. Four patients were excluded due to the presence of metastatic disease or stage TX. Late toxicity data were available for 120 patients. Results: Median cumulative IMRT dose was 51.25 Gy (median, 28 fractions). All but 2 patients received chemotherapy. With median follow-up of 26.8 months, local control at 3 years was 87%, worse for patients with T3-T4 than T1-T2 disease on univariate analysis (79% vs. 90%; P = 0.04). Regional control, distant control, and overall survival were 97%, 91%, and 87%, respectively, at 3 years. Nodal status was associated with regional control, distant control, and overall survival (P < 0.01 for each). Most common severe acute toxicity was hematologic (41%), skin (20%), and gastrointestinal tract (11%). Two grade 5 toxicities occurred (hematologic and gastrointestinal tract). Severe late toxicity affected skin (1%) and gastrointestinal tract (3%). Conclusions: IMRT with chemotherapy resulted in excellent local control. Although T stage predicted worse local control, most T3-T4 disease was controlled with IMRT. Nodal status predicted regional and distant control and overall survival. Severe toxicity was acceptable.

KW - Anal cancer

KW - Chemoradiotherapy

KW - Chemotherapy

KW - Combined modality

KW - Intensity-modulated radiation therapy

KW - Squamous cellcarcinoma

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