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Document type:
journal article 
Author(s):
Koerber, Stefan Alexander; Slynko, Alla; Haefner, Matthias F; Krug, David; Schoneweg, Clara; Kessel, Kerstin; Kopp-Schneider, Annette; Herfarth, Klaus; Debus, Juergen; Sterzing, Florian 
Title:
Efficacy and toxicity of chemoradiation in patients with anal cancer--a retrospective analysis. 
Abstract:
Concurrent chemotherapy and radiation therapy is the preferred standard of care for patients with anal cancer. Several studies have suggested a benefit of intensity-modulated radiation therapy (IMRT) compared with 3D-conformal radiation (3D-CRT) regarding acute toxicity. This study evaluates outcome and toxicity of patients undergoing IMRT/Tomotherapy or 3D-CRT at our institution.A cohort of 105 anal cancer patients was treated with chemoradiation or radiation alone (16.2%) between January 2000 and December 2011. 37 patients received 3D-CRT while 68 patients were treated with IMRT. Follow-up exams were performed every 3 to 6 months for a minimum of 3 years and then annually.Median follow-up was 41.4 months (2.8 - 158.4). Overall survival (OS), Progression-free survival (PFS) and local control (LC) at 3 years was 70.3%, 66.5%, 78.3% in the 3D-CRT group and 82.9%, 66.5%, 75.3% in the IMRT group without statistically significant difference. 3-year Colostomy-free survival (CFS) was 85.7% in the IMRT/Tomotherapy group and 91.8% in the 3D-CRT group (p = 0.48). No grade 4 toxicity was found in both groups. Severe (G2/3) acute skin toxicity (94.6% vs. 63.2%; p< 0.001) and acute gastrointestinal toxicity rate (67.6% vs. 47.1%; p = 0.03) was significantly higher with 3D-CRT compared to IMRT/Tomotherapy.The use of IMRT can reduce acute severe side effects of the skin and gastrointestinal tract but did not demonstrate improved results regarding OS, PFS, LC and CFS. 
Journal title abbreviation:
Radiat Oncol 
Year:
2014 
Journal volume:
Pages contribution:
113 
Language:
eng 
TUM Institution:
Klinik und Poliklinik für RadioOnkologie und Strahlentherapie