Radiation dose associated with local control in advanced anal cancer: Retrospective analysis of 129 patients

Joachim Widder*, Reinhard Kastenberger, Elisabeth Fercher, Rainer Schmid, Johannes A. Langendijk, Werner Dobrowsky, Richard Poetter

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

41 Citations (Scopus)

Abstract

Background and purpose: To retrospectively analyse a large consecutive cohort of patients with anal cancer for treatment-related factors influencing local control and survival.

Materials and methods: All patients referred for primary radiotherapy at Medical University of Vienna in 1990-2002 with anal canal carcinoma without distant metastases were analysed. Treatment consisted of external radiotherapy with or without brachytherapy and with or without chemotherapy. Patient-, tumour-, and treatment-factors were tested for influence on survival and local control using Cox multivariate analysis.

Results: Median age was 67 years (n = 129), the UICC stage distribution was 15%, 58%, and 27% for stages I, II, and III, respectively. With median follow-up of 8.0 years for surviving patients (3.9 years including deceased patients), five-year overall survival and disease-free-survival were 57% and 51%, respectively. Local control at 5 years was 87%. Stage and age were significant factors for overall and colostomy-free-survival, N-stage for disease-free-survival. Shorter overall treatment time favoured local control in stage T1-2 (p = .015), higher total radiation dose and female gender were associated with improved local control in T3-4 tumours (p = .021).

Conclusions: These results support potential improvement of anal cancer treatment by studying advanced technology such as IMRT, making it possible to tailor high-dose regions. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)367-375
Number of pages9
JournalRadiotherapy and Oncology
Volume87
Issue number3
DOIs
Publication statusPublished - Jun-2008

Keywords

  • anal cancer or carcinoma
  • chemoradiation
  • dose-response
  • radiotherapy
  • SQUAMOUS-CELL CARCINOMA
  • EXTERNAL-BEAM RADIOTHERAPY
  • POPULATION-BASED SERIES
  • QUALITY-OF-LIFE
  • CANAL CARCINOMA
  • EPIDERMOID CARCINOMA
  • CONSERVATIVE TREATMENT
  • RATE BRACHYTHERAPY
  • CONCOMITANT CHEMOTHERAPY
  • PROGNOSTIC-FACTORS

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