Role of brachytherapy in the treatment of cancers of the anal canal : Long-term follow-up and multivariate analysis of a large monocentric retrospective series = Stellenwert der Brachytherapie bei der Behandlung von Tumoren des Analkanals : Langzeit-Follow-up und multivariate Analyse einer großen monozentrischen, retrospektiven Studie
Lestrade, Laëtitia ; De Bari, Berardino ; Pommier, Pascal ; Montbarbon, Xavier ; Lavergne, Emilie ; Ardiet, Jean-Michel ; Carrie, Christian
In: Strahlentherapie und Onkologie, 2014, vol. 190, no. 6, p. 546-554
Ajouter à la liste personnelle- Summary
- Background and purpose: There are few data on long-term clinical results and tolerance of brachytherapy in anal canal cancer. We present one of the largest retrospective analyses of anal canal cancers treated with external beam radiotherapy with/without (±) chemotherapy followed by a brachytherapy boost. Materials and methods: We performed a retrospective analysis of clinical results in terms of efficacy and toxicity. The impact of different clinical and therapeutic variables on these outcomes was studied. Results: From May 1992 to December 2009, 209 patients received brachytherapy after external beam radiotherapy ± chemotherapy. Of these patients, 163 were stage II or stage IIIA (UICC 2002) and 58 were N1-3. According to age, ECOG performance status (PS), and comorbidities, patients received either radiotherapy alone (58/209) or radiochemotherapy (151/209). The median follow-up was 72.8months. The 5- and 10-year local control rates were 78.6 and 73.9 %, respectively. Globally, severe acute and late G3-4 reactions (NCI-CTC scale v. 4.0) occurred in 11.2 and 6.3 % of patients, respectively. Univariate analysis showed the statistical impact of the pelvic treatment volume (p = 0.046) and of the total dose (p = 0.02) on the risk of severe acute and late toxicities, respectively. Only six patients required permanent colostomy because of severe late anorectal toxicities. Conclusion: After a long follow-up time, brachytherapy showed an acceptable toxicity profile and high local control rates in patients with anal canal cancer.