T1-2 anal carcinoma requires elective inguinal radiation treatment – The results of Trans Tasman Radiation Oncology Group study TROG 99.02
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| Title: | T1-2 anal carcinoma requires elective inguinal radiation treatment – The results of Trans Tasman Radiation Oncology Group study TROG 99.02 |
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| Authors: | Matthews, John H.L.1 johnmatt@ihug.co.nz, Burmeister, Bryan H.2, Borg, Martin3, Capp, Anne L.4, Joseph, David5, Thompson, Kerin M.1, Thompson, Paul I.6, Harvey, Jennifer A.7, Spry, Nigel A.8 |
| Source: | Radiotherapy & Oncology. Jan2011, Vol. 98 Issue 1, p93-98. 6p. |
| Subjects: | Cancer radiotherapy, Anal cancer treatment, Cancer chemotherapy, Fluorouracil, Survival analysis (Biometry), Mitomycin C |
| Abstract: | Abstract: Background and purpose: Elective inguinal irradiation increases morbidity. We describe outcomes of moderate intensity chemoradiation treating anal canal and adjacent pelvic nodes only. Material and methods: Forty patients with T1-2, N0 anal carcinoma were enrolled between March 1999 and March 2003. Inguinal nodes were NOT electively irradiated. The anal canal and regional pelvic nodes received 36Gy/20# over 4weeks, and 2weeks later the anal canal was boosted with 14.4Gy/8#. Chemotherapy was 5 fluorouracil 800mg/m2/day on days 1–4 and 36–39, and Mitomycin C 10mg/m2 on day 1. Results: Median follow-up was 44months. Complete response was 95%. Four year results were; overall survival 71%, local control 82%, and colostomy-free survival (including salvage) 85%. Inguinal failure occurred in 22.5% but was isolated in only 12.5%. Treatment was well tolerated acutely with no toxic deaths. Severe late toxicity occurred in 7.5%. Conclusions: This moderate dose ‘non inguinal’ chemoradiation regimen resulted in modest acute toxicity, minimal long term morbidity and local control in line with other series. However staging failed to identify 12.5% of patients whose isolated inguinal failure might have been prevented by elective irradiation. Without more effective staging, all patients should receive elective inguinal irradiation. [ABSTRACT FROM AUTHOR] |
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| Database: | Engineering Source |
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