TY - JOUR
T1 - Feasibility of weekly cisplatin and radiotherapy for localized anal cancer – A Danish anal cancer group report
AU - Vittrup Jakobsen, Anne
AU - Jensenius Skovhus Kronborg, Camilla
AU - Kjer Oksen, Rikke
AU - Mayland Havelund, Birgitte
AU - Lycke Wind, Karen
AU - Garm Spindler, Karen Lise
PY - 2024/10
Y1 - 2024/10
N2 - Background: Chemoradiotherapy (CRT) with flourouracil and mitomycin is the standard treatment for squamous cell carcinomas of the anus (SCCA), however the associated acute toxicity often hinders compliance. Although weekly cisplatin is a well-established treatment for other squamous cell carcinomas, it has not been explored in SCCA. Purpose: To investigate if radiotherapy (RT) with weekly cisplatin is a feasible option for SCCA and to report the acute toxicity. Material/methods: Patients were treated with RT and weekly cisplatin 40 mg/m2 between 1998–2020. Retrospective data from medical records (n=65) and prospectively collected data from an observational study (n=51) comprising physician assessed toxicity (NCI-CTCAE 4.0), patient-reported outcomes (EORTC-QlQC30 + CR29) baseline, mid-therapy, end of treatment and 2–4 weeks post-treatment were included. Disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Results: We included 116 patients. T-stages were T1:4%, T2: 71%, T3: 17%, T4: 8% and 47% has N+ disease. RT doses were 53.75–64 Gy/45–51.2 Gy and the mean cumulative dose of cisplatin was 307.5 mg. The median overall treatment time was 43 days. Within 6 months after CRT 88.9 % had complete response. The median follow-up time was 4.5 years and 5-year DFS and OS were 77% (95%CI 68.7;84.5%) and 86.4% (95%CI 78.3;91.7%), respectively. Hospitalization occured in 20% with 2.6% being admitted due to febrile neutropenia. Hematological toxicity was low with 13.7% grade 3 and 3.9% grade 4. Anal pain, skin, gastrointestinal and urogenital toxicity were mild. Conclusion: RT and weekly cisplatin for SCCA showed good outcome results and an acceptable acute toxicity profile.
AB - Background: Chemoradiotherapy (CRT) with flourouracil and mitomycin is the standard treatment for squamous cell carcinomas of the anus (SCCA), however the associated acute toxicity often hinders compliance. Although weekly cisplatin is a well-established treatment for other squamous cell carcinomas, it has not been explored in SCCA. Purpose: To investigate if radiotherapy (RT) with weekly cisplatin is a feasible option for SCCA and to report the acute toxicity. Material/methods: Patients were treated with RT and weekly cisplatin 40 mg/m2 between 1998–2020. Retrospective data from medical records (n=65) and prospectively collected data from an observational study (n=51) comprising physician assessed toxicity (NCI-CTCAE 4.0), patient-reported outcomes (EORTC-QlQC30 + CR29) baseline, mid-therapy, end of treatment and 2–4 weeks post-treatment were included. Disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Results: We included 116 patients. T-stages were T1:4%, T2: 71%, T3: 17%, T4: 8% and 47% has N+ disease. RT doses were 53.75–64 Gy/45–51.2 Gy and the mean cumulative dose of cisplatin was 307.5 mg. The median overall treatment time was 43 days. Within 6 months after CRT 88.9 % had complete response. The median follow-up time was 4.5 years and 5-year DFS and OS were 77% (95%CI 68.7;84.5%) and 86.4% (95%CI 78.3;91.7%), respectively. Hospitalization occured in 20% with 2.6% being admitted due to febrile neutropenia. Hematological toxicity was low with 13.7% grade 3 and 3.9% grade 4. Anal pain, skin, gastrointestinal and urogenital toxicity were mild. Conclusion: RT and weekly cisplatin for SCCA showed good outcome results and an acceptable acute toxicity profile.
KW - Anal cancer
KW - Chemotherapy
KW - PROM
KW - Radiotherapy
KW - Toxicity
UR - http://www.scopus.com/inward/record.url?scp=85200134123&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2024.110422
DO - 10.1016/j.radonc.2024.110422
M3 - Journal article
C2 - 39002571
AN - SCOPUS:85200134123
SN - 0167-8140
VL - 199
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
M1 - 110422
ER -