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1. Iagaru A, Kundu R, Jadvar H, Nagle D: Evaluation by 18F-FDG-PET of patients with anal squamous cell carcinoma. Hell J Nucl Med; 2009 Jan-Apr;12(1):26-9
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  • [Title] Evaluation by 18F-FDG-PET of patients with anal squamous cell carcinoma.
  • Anal squamous cell carcinoma (ASCC) is a rare cancer of the gastrointestinal tract, representing less than 5% of the digestive malignancies.
  • A total of 14 (18)F-FDG PET scans (8 for initial staging, 6 for evaluation of response to chemotherapy and radiation therapy) were performed in 8 patients (6 men, 2 women).
  • Our results showed that PET demonstrated the primary lesion at initial evaluation in 7 of 8 anal cancers and showed FDG- avid lymph nodes in 4 patients.
  • In another patient, follow-up PET demonstrated progression of disease despite treatment, prompting a change in disease management.
  • In the remaining 5 patients with follow-up PET, the scans confirmed interval resolution of the (18)F-FDG uptake in the primary lesion, suggesting good treatment response.
  • In conclusion, PET provides valuable diagnostic information in initial staging and evaluation of treatment response in ASCC that may significantly alter the clinical management.
  • The emergence of the combined PET/CT scanner enhanced the accuracy of the imaging procedure in view of the precise anatomic localization of metabolic abnormalities.
  • [MeSH-major] Anus Neoplasms / radionuclide imaging. Carcinoma, Squamous Cell / radionuclide imaging. Fluorodeoxyglucose F18. Positron-Emission Tomography / methods

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  • (PMID = 19330178.001).
  • [ISSN] 1790-5427
  • [Journal-full-title] Hellenic journal of nuclear medicine
  • [ISO-abbreviation] Hell J Nucl Med
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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2. Oehler-Jänne C, Seifert B, Lütolf UM, Ciernik IF: Local tumor control and toxicity in HIV-associated anal carcinoma treated with radiotherapy in the era of antiretroviral therapy. Radiat Oncol; 2006;1:29
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  • [Title] Local tumor control and toxicity in HIV-associated anal carcinoma treated with radiotherapy in the era of antiretroviral therapy.
  • PURPOSE: To investigate the outcome of HIV-seropositive patients under highly active antiretroviral treatment (HAART) with anal cancer treated with radiotherapy (RT) alone or in combination with standard chemotherapy (CT).
  • PATIENTS AND METHODS: Clinical outcome of 81 HIV-seronegative patients (1988-2003) and 10 consecutive HIV-seropositive patients under HAART (1997-2003) that were treated with 3-D conformal RT of 59.4 Gy and standard 5-fluorouracil and mitomycin-C were retrospectively analysed.
  • Pattern of care, local disease control (LC), overall survival (OS), cancer-specific survival (CSS), and toxicity were assessed.
  • No HIV-seropositive patient received an interstitial brachytherapy boost compared to 42% of all HIV-seronegative patients and adherence to chemotherapy seemed to be difficult in HIV-seropositive patients.
  • CONCLUSION: Despite high response rates to organ preserving treatment with RT with or without CT, local tumor failure seems to be high in HIV-positive patients receiving HAART.
  • HIV-seropositive patients are subject to treatment bias, being less likely treated with interstitial brachytherapy boost probably due to HIV-infection, and they are at risk to receive less chemotherapy.
  • [MeSH-major] Antiretroviral Therapy, Highly Active. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Anus Neoplasms / virology. HIV Infections / complications. HIV Infections / drug therapy. Radiotherapy / methods
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents / therapeutic use. Combined Modality Therapy / methods. Female. Fluorouracil / therapeutic use. HIV Seropositivity. Humans. Male. Middle Aged. Mitomycin / therapeutic use. Retrospective Studies. Treatment Outcome


3. Eng C, Pathak P: Treatment options in metastatic squamous cell carcinoma of the anal canal. Curr Treat Options Oncol; 2008 Dec;9(4-6):400-7
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  • [Title] Treatment options in metastatic squamous cell carcinoma of the anal canal.
  • Squamous cell carcinoma of the anal canal is a rare malignancy that is often cured with the combined modality therapy of chemoradiation.
  • Consideration of platinum-based systemic chemotherapy is commonly provided for palliation with the optimal duration of therapy being largely unknown; the role of biologics and/or surgical resection of metastatic disease are anecdotal.
  • Patients with no contraindications to systemic chemotherapy should be treated aggressively with consideration of multidisciplinary management if appropriate.
  • Here, we present a summary of the existing literature in the treatment of metastatic anal carcinoma in the hopes of providing insight and potential treatment alternatives for the practicing physician.
  • [MeSH-major] Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carboplatin / therapeutic use. Combined Modality Therapy. Female. Fluorouracil / therapeutic use. Humans. Incidence. Male. Mitomycin / therapeutic use. Radiotherapy. Sexually Transmitted Diseases / transmission. United States / epidemiology

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  • (PMID = 19479383.001).
  • [ISSN] 1534-6277
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 50SG953SK6 / Mitomycin; BG3F62OND5 / Carboplatin; U3P01618RT / Fluorouracil
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4. Mullen JT, Rodriguez-Bigas MA, Chang GJ, Barcenas CH, Crane CH, Skibber JM, Feig BW: Results of surgical salvage after failed chemoradiation therapy for epidermoid carcinoma of the anal canal. Ann Surg Oncol; 2007 Feb;14(2):478-83
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  • [Title] Results of surgical salvage after failed chemoradiation therapy for epidermoid carcinoma of the anal canal.
  • BACKGROUND: The standard treatment for epidermoid carcinoma of the anal canal consists of combined radiation and chemotherapy.
  • For patients who present with persistent or locally recurrent disease, salvage abdominoperineal resection is the treatment of choice.
  • METHODS: From 1990-2002, 31 patients underwent radical salvage surgery with curative intent after failure of initial sphincter-conserving therapy, and the medical records of these patients were retrospectively reviewed.
  • The median follow-up time was 29 months.
  • Twelve patients developed recurrent disease after radical salvage surgery.
  • Patients who received an initial radiation dose of less than 55 Gy had a significantly worse survival than those who received at least 55 Gy as part of their initial treatment (5-year overall survival 37.5% vs. 75%; age-adjusted hazard ratio 8.2 [95% CI: 1.1-59.8], P = .037).
  • Factors that were not found to have an impact on survival included the presence of persistent versus recurrent disease, tumor (T) stage, and margin status of resection.
  • CONCLUSIONS: Long-term survival following salvage surgery for persistent or locally recurrent epidermoid carcinoma of the anal canal can be achieved in the majority of patients.
  • However, patients who initially present with node-positive disease and patients who receive a radiation dose of less than 55 Gy as part of their initial chemoradiation therapy regimen have a worse prognosis after radical salvage surgery.
  • [MeSH-major] Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy. Neoplasm Recurrence, Local / surgery. Neoplasm, Residual / surgery
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Colectomy. Female. Humans. Male. Middle Aged. Radiotherapy. Survival Analysis. Treatment Failure. Treatment Outcome

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  • (PMID = 17103253.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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5. Laglera S, Sánchez-Tirado JA, Rasal S, Martínez-Diestre MD, Lafuente F, Ruiz J: [Hypertonic saline 7.5% in the treatment of severe hypochloremic metabolic alkalosis]. Rev Esp Anestesiol Reanim; 2002 Dec;49(10):545-9
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  • [Title] [Hypertonic saline 7.5% in the treatment of severe hypochloremic metabolic alkalosis].
  • [Transliterated title] Suero salino hipertónico 7,5% en el tratamiento de la alcalosis metabólica hipoclorémica grave.
  • A 63 year-old man with a history of anal carcinoma treated by surgery, chemotherapy and radiotherapy was admitted to our hospital two years later with small bowel obstruction requiring emergency surgery.
  • During the procedure, severe metabolic alkalosis developed: pH 7.58, CO3H- 47.7 mmol/L and a base excess of 24.3 mmol/L.
  • Response to treatment was good as elevated values fell to acceptable levels within two hours.
  • [MeSH-major] Alkalosis / drug therapy. Saline Solution, Hypertonic / therapeutic use

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  • (PMID = 12677976.001).
  • [ISSN] 0034-9356
  • [Journal-full-title] Revista española de anestesiología y reanimación
  • [ISO-abbreviation] Rev Esp Anestesiol Reanim
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Spain
  • [Chemical-registry-number] 0 / Saline Solution, Hypertonic; 712K4CDC10 / Hypochlorous Acid
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6. Oehler-Jänne C, Seifert B, Lütolf UM, Studer G, Glanzmann C, Ciernik IF: Clinical outcome after treatment with a brachytherapy boost versus external beam boost for anal carcinoma. Brachytherapy; 2007 Jul-Sep;6(3):218-26
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical outcome after treatment with a brachytherapy boost versus external beam boost for anal carcinoma.
  • PURPOSE: To evaluate the outcome after definitive whole pelvis external beam radiotherapy (EBRT) followed by brachytherapy (BT) boost after treatment break vs. external beam boost without break in the treatment of anal carcinoma.
  • METHODS AND MATERIALS: Eighty-one consecutive patients with invasive anal carcinoma were analyzed retrospectively.
  • Concomitant chemotherapy (CT) with mitomycin C was applied during whole pelvis EBRT depending on tumor stage.
  • Pattern of care, local disease control (LC), cancer-specific survival (CSS), overall survival (OS), toxicity, and quality of life (QOL) were assessed.
  • In all patients, BT boost did not result in improved LC, OS, and CSS compared with EBRT boost, despite stage and treatment bias favoring small tumors to be treated with BT.
  • Acute skin toxicity was less common in the BT boost group (whole cohort: p=0.14; Stages I-IIIa: p=0.05), but long-term morbidity and QOL were similar.
  • Acute skin toxicity is reduced with BT boost but long-term morbidity and QOL are identical.
  • [MeSH-major] Anus Neoplasms / radiotherapy. Brachytherapy / instrumentation. Carcinoma / radiotherapy
  • [MeSH-minor] Disease-Free Survival. Dose-Response Relationship, Radiation. Equipment Design. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 17681244.001).
  • [ISSN] 1538-4721
  • [Journal-full-title] Brachytherapy
  • [ISO-abbreviation] Brachytherapy
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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7. Ryan DP, Mayer RJ: Anal carcinoma: histology, staging, epidemiology, treatment. Curr Opin Oncol; 2000 Jul;12(4):345-52
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  • [Title] Anal carcinoma: histology, staging, epidemiology, treatment.
  • Our understanding of the pathogenesis and management of squamous cell carcinoma of the anal canal has undergone profound change over the last 30 years.
  • Primary treatment with concomitant chemotherapy and radiation cures the majority of patients without the need for an abdominoperineal resection.
  • The incorporation of cisplatin into the primary chemoradiation treatment of patients with carcinoma of the anal canal is the focus of current studies.
  • [MeSH-major] Adenocarcinoma. Anus Neoplasms. Carcinoma, Small Cell. Carcinoma, Squamous Cell
  • [MeSH-minor] Combined Modality Therapy. Humans. Neoplasm Recurrence, Local. Neoplasm Staging

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  • (PMID = 10888420.001).
  • [ISSN] 1040-8746
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] UNITED STATES
  • [Number-of-references] 93
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8. Fayaz S, Vasishta S, Motawy M: Case report of long term survivor of metastatic cloacogenic carcinoma of the anal canal with chemotherapy. Gulf J Oncolog; 2007 Jul;(2):65-8
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  • [Title] Case report of long term survivor of metastatic cloacogenic carcinoma of the anal canal with chemotherapy.
  • A fifty-two years old Egyptian lady, case of cloacogenic carcinoma of anal canal with extensive liver metastasis showed complete remission with 5-Fluorouracil (5FU) and Cis-Dichlorodiammineplatinum(CDDP) chemotherapy only and remains disease free five & haf years after therapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Carcinoma, Squamous Cell / drug therapy. Liver Neoplasms / drug therapy. Survivors
  • [MeSH-minor] Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Middle Aged. Survival Rate. Treatment Outcome

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  • (PMID = 20084726.001).
  • [ISSN] 2078-2101
  • [Journal-full-title] The Gulf journal of oncology
  • [ISO-abbreviation] Gulf J Oncolog
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Kuwait
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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9. Szilagy EJ, Farid A: Anal Carcinoma. Curr Treat Options Gastroenterol; 2001 Jun;4(3):275-279
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  • [Title] Anal Carcinoma.
  • Carcinoma of the anus is a rare malignancy that usually is diagnosed at an advanced stage, in spite of being easily visible and accessible.
  • Its treatment has evolved from being mainly surgical to one consisting of chemotherapy (with fluorouracil and mitomycin) and radiation (megavoltage linear accelerator therapy delivering between 40 to 50 Gy).
  • Local surgical excision is most often performed for either carcinoma in situ or microinvasive lesions of the anal margin.

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  • (PMID = 11469985.001).
  • [ISSN] 1092-8472
  • [Journal-full-title] Current treatment options in gastroenterology
  • [ISO-abbreviation] Curr Treat Options Gastroenterol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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10. Levitsky J, Hong JJ, Jani AB, Ehrenpreis ED: Oral vitamin a therapy for a patient with a severely symptomatic postradiation anal ulceration: report of a case. Dis Colon Rectum; 2003 May;46(5):679-82
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Oral vitamin a therapy for a patient with a severely symptomatic postradiation anal ulceration: report of a case.
  • Squamous-cell carcinoma of the anus is an uncommon but treatable gastrointestinal malignancy.
  • Radiation, in addition to chemotherapy, is widely accepted as the standard of care for treatment in most patients.
  • However, significant anal complications, such as stricture, fistula, and ulceration, may result from radiation therapy.
  • Some medical therapies have been used for radiation proctopathy, but treatments for radiation-induced anal injury other than surgical diversion are unknown.
  • However, it has not been used clinically in patients with radiation enteritis, proctopathy, or anal ulceration.
  • We report a case of a patient with human immunodeficiency virus infection who developed a symptomatic anal ulcer after receiving high-dose radiotherapy for anal squamous-cell carcinoma.
  • We prescribed 8,000 IU of oral vitamin A twice daily and within seven weeks his anorectal symptoms and anal ulcer completely resolved.
  • Vitamin A seems to be very effective in the treatment of radiation-induced anorectal damage, with little toxicity and expense.
  • [MeSH-major] Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / radiotherapy. Fissure in Ano / drug therapy. Radiation Injuries / drug therapy. Vitamin A / administration & dosage
  • [MeSH-minor] Administration, Oral. Adult. Combined Modality Therapy. HIV Infections / complications. Humans. Male. Treatment Outcome

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  • (PMID = 12792447.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 11103-57-4 / Vitamin A
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11. Gupta AK, Cherman AM, Tyring SK: Viral and nonviral uses of imiquimod: a review. J Cutan Med Surg; 2004 Sep-Oct;8(5):338-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: Imiquimod is a topical immunomodulator that is indicated for the treatment of external genital and perianal warts.
  • This drug has been recently approved for the treatment of actinic keratoses and superficial basal cell carcinoma.
  • There is a growing body of evidence for its effectiveness in treating a variety of other skin conditions.
  • OBJECTIVE: This review examines the role of imiquimod 5% cream in the treatment of skin diseases such as actinic keratoses, basal cell carcinoma, Bowen's disease, lentigo maligna, and extramammary Paget's disease.
  • Side effects are generally well tolerated with local skin reactions reported most frequently.
  • CONCLUSION: Imiquimod has been shown to be a safe and effective treatment for a variety of skin conditions.
  • [MeSH-major] Adjuvants, Immunologic / therapeutic use. Aminoquinolines / therapeutic use. Antineoplastic Agents / therapeutic use. Antiviral Agents / therapeutic use. Skin Diseases / drug therapy
  • [MeSH-minor] Administration, Topical. Bowen's Disease / drug therapy. Carcinoma, Basal Cell / drug therapy. Clinical Trials, Phase III as Topic. Condylomata Acuminata / drug therapy. Humans. Hutchinson's Melanotic Freckle / drug therapy. Keratosis / drug therapy. Models, Immunological. Ointments. Paget Disease, Extramammary / drug therapy. Randomized Controlled Trials as Topic. Skin Neoplasms / drug therapy

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  • (PMID = 15868314.001).
  • [ISSN] 1203-4754
  • [Journal-full-title] Journal of cutaneous medicine and surgery
  • [ISO-abbreviation] J Cutan Med Surg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / Aminoquinolines; 0 / Antineoplastic Agents; 0 / Antiviral Agents; 0 / Ointments; P1QW714R7M / imiquimod
  • [Number-of-references] 112
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12. Sudore RL, Villars P, Carey EC: Sitting with you in your suffering: lessons about intractable pain at the end of life. J Palliat Med; 2010 Jun;13(6):779-82
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • We review a case of a 63-year-old man with anal squamous cell carcinoma who was transferred from an inpatient hospice unit to an intensive care setting in an ill-fated attempt to alleviate his pain and suffering.
  • In retrospect, there were likely many system factors that may have contributed to this patient's ongoing suffering, including restrictions on the use of certain medications by location (i.e., hospice unit versus intensive care setting) as well as medication and ordering misunderstandings.
  • [MeSH-minor] Carcinoma, Squamous Cell / drug therapy. Humans. Male. Medical Futility / psychology. Middle Aged. Palliative Care

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  • (PMID = 20509794.001).
  • [ISSN] 1557-7740
  • [Journal-full-title] Journal of palliative medicine
  • [ISO-abbreviation] J Palliat Med
  • [Language] eng
  • [Grant] United States / PHS HHS / / 1K01HP00125-01
  • [Publication-type] Case Reports; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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13. Fraunholz I, Rabeneck D, Weiss C, Rödel C: Combined-modality treatment for anal cancer: current strategies and future directions. Strahlenther Onkol; 2010 Jul;186(7):361-6
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  • [Title] Combined-modality treatment for anal cancer: current strategies and future directions.
  • BACKGROUND: Concurrent chemoradiotherapy (CRT) with 5-fluorouracil (5-FU) and mitomycin C (MMC) is the treatment of choice for anal carcinoma.
  • The most appropriate radiation (RT) dose, fractionation, techniques, and the most effective chemotherapy regimen (agents, number of neoadjuvant, concomitant, adjuvant cycles) remain to be established.
  • MATERIAL AND METHODS: This review article focuses on recent randomized trials designed to improve standard 5-FU/MMC-based CRT through the inclusion of (induction, concurrent, maintenance) cisplatin, and describes developments in combining RT with other chemotherapeutic drugs and targeted therapies.
  • RESULTS: Based on results of three recent randomized phase III trials, neither induction chemotherapy (RTOG 98-11, ACCORD 03) or maintenance chemotherapy with 5-FU/cisplatin (ACT II) nor RT dose escalation (ACCORD 03) improved the outcome of concurrent 5-FU/MMC-CRT.
  • CONCLUSION: Concurrent 5-FU/MMC-CRT without induction or maintenance chemotherapy remains the standard of care for anal cancer patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Combined Modality Therapy. Dose Fractionation. Dose-Response Relationship, Radiation. Fluorouracil / administration & dosage. Humans. Mitomycin / administration & dosage. Neoadjuvant Therapy. Patient Care Team. Randomized Controlled Trials as Topic


14. Grabenbauer GG, Kessler H, Matzel KE, Sauer R, Hohenberger W, Schneider IH: Tumor site predicts outcome after radiochemotherapy in squamous-cell carcinoma of the anal region: long-term results of 101 patients. Dis Colon Rectum; 2005 Sep;48(9):1742-51
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  • [Title] Tumor site predicts outcome after radiochemotherapy in squamous-cell carcinoma of the anal region: long-term results of 101 patients.
  • PURPOSE: This study was designed to assess the long-term results following radiochemotherapy in patients with anal squamous-cell carcinoma and to evaluate the impact of tumor location on response, survival, and colostomy-free survival.
  • PATIENTS AND METHODS: Between 1985 and 2001, a total of 101 patients with anal carcinoma were registered for curative treatment, of whom 77 had involvement of the anal canal alone, 10 cases had extension into the perianal skin, and 14 patients had pure anal margin tumors.
  • Small tumors of the anal margin were not included since they were treated by surgical excision only.
  • T categories (International Union against Cancer) were T1 (15), T2 (36), T3 (34), and T4 (16).
  • Radiation treatment was directed to the primary tumor region and to the inguinal, perirectal, and internal iliac nodes using a three-field to four-field box technique with 10MV photons up to a total dose of 5040 cGy.
  • All patients were scheduled for simultaneous chemotherapy with two cycles of 5-fluorouracil at a dose of 1000 mg/m (2)/day as 120 hours of continuous intravenous infusion on Days 1 to 5 and 29 to 33 and mitomycin C at 10 mg/m (2)/day on Days 1 and 29.
  • Median follow-up time was was 7.5 (range, 1-16) years.
  • RESULTS: Overall survival and colostomy-free survival rates for patients with anal canal cancer were 75 percent and 87 percent at five years, respectively.
  • Patients with anal margin cancer had a less favorable outcome with five-year-overall and colostomy-free survival rates of 54 percent and 69 percent, respectively.
  • After correction for imbalance between anal canal and anal margin tumors, i.e., exclusion of T1 tumors of the anal canal, difference in overall survival remained significant (73 percent vs. 54 percent, P = 0.01).
  • Following multivariate analysis, tumor location (anal canal vs. anal margin, P = 0.02), age (P = 0.003), and dose intensity of chemotherapy (< or =75 percent vs. >75 percent, P = 0.03) remained independent significant factors for overall survival.
  • CONCLUSIONS: With colostomy-free survival rates around 85 percent, long-term treatment results for anal canal carcinoma have reached a satisfactory level.
  • However, patients with larger lesions of the perianal skin are at high risk for locoregional recurrence and possible treatment intensification in this subgroup seems desirable.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Neoplasm Recurrence, Local. Neoplasm Staging. Prognosis. Proportional Hazards Models. Survival Analysis. Treatment Outcome

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  • (PMID = 15991058.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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15. Meyer J, Willett C, Czito B: Current and emerging treatment strategies for anal cancer. Curr Oncol Rep; 2010 May;12(3):168-74
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  • [Title] Current and emerging treatment strategies for anal cancer.
  • Concurrent radiotherapy and chemotherapy (5-fluorouracil and mitomycin-C) is established as a sphincter-preserving treatment for squamous cell carcinoma of the anal canal.
  • However, there is room for improvement in rates of tumor control as well as a need to reduce treatment-induced toxicity.
  • Efforts are underway to test the value of newer radiosensitizing chemotherapeutic and molecular targeted agents, as well as to establish the value of advances in radiation therapy planning and delivery.
  • This review discusses the evolution of therapy for anal cancer, from early clinical trials establishing the current standard to more recent studies evaluating cisplatin, capecitabine, oxaliplatin, and cetuximab.
  • Early clinical results from studies incorporating intensity-modulated radiation therapy are also discussed.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy
  • [MeSH-minor] Combined Modality Therapy. Humans. Radiotherapy

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  • (PMID = 20425076.001).
  • [ISSN] 1534-6269
  • [Journal-full-title] Current oncology reports
  • [ISO-abbreviation] Curr Oncol Rep
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 30
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16. Perera D, Pathma-Nathan N, Rabbitt P, Hewett P, Rieger N: Sentinel node biopsy for squamous-cell carcinoma of the anus and anal margin. Dis Colon Rectum; 2003 Aug;46(8):1027-9; discussion 1030-1
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  • [Title] Sentinel node biopsy for squamous-cell carcinoma of the anus and anal margin.
  • PURPOSE: The majority of anal tumors are squamous-cell carcinomas.
  • These may be tumors of the anal canal or margin.
  • They are best treated by combination of chemotherapy and radiotherapy.
  • METHODS: Patients with anal squamous-cell carcinoma had four injections of 0.2 ml of antimony sulfide (30 MBq) around the tumor.
  • Under a gamma camera, a distant high-intensity signal was located, and this point was marked on the overlying skin using an indelible ink pen.
  • RESULTS: This procedure was performed on 12 patients.
  • In two patients, metastatic squamous-cell carcinoma was identified histologically in the sentinel node.
  • CONCLUSION: We advocate that this as a safe technique for detecting metastatic disease in the inguinal nodes in patients with anal squamous-cell carcinoma.
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma, Squamous Cell / pathology. Sentinel Lymph Node Biopsy / methods

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  • (PMID = 12907894.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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17. Liapakis IE, Korkolis DP, Koutsoumbi A, Kokkalis G, Gherardini G, Vassilopoulos PP: Merkel cell carcinoma: clinicopathological aspects of an unusual neoplasm. J BUON; 2007 Apr-Jun;12(2):173-9
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  • [Title] Merkel cell carcinoma: clinicopathological aspects of an unusual neoplasm.
  • Merkel cell carcinoma (MCC) is a rare, aggressive cutaneous cancer that predominately affects elderly Caucasians with fair skin and has a propensity for local recurrence and regional lymph node metastases.
  • It can occur on the face, the trunk, the genitalia, and the perianal region.
  • It may be difficult to accurately diagnose MCC by light microscopy alone and ancillary techniques, including electron microscopy and immunohistochemistry, may be necessary for a definitive diagnosis.
  • Nonetheless, for localized disease most guidelines include wide local excision of the primary tumor either alone or followed by radiation therapy.
  • Systemic chemotherapy may be considered as an adjuvant following surgery or to treat locoregional or distant disease.
  • [MeSH-major] Carcinoma, Merkel Cell / diagnosis. Carcinoma, Merkel Cell / therapy. Skin Neoplasms / diagnosis. Skin Neoplasms / therapy
  • [MeSH-minor] Head and Neck Neoplasms / diagnosis. Head and Neck Neoplasms / pathology. Head and Neck Neoplasms / surgery. Head and Neck Neoplasms / therapy. Humans. Lymphatic Metastasis. Neoplasm Recurrence, Local. Neoplasm Staging. Prognosis. Radiotherapy, Adjuvant. Sentinel Lymph Node Biopsy

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  • (PMID = 17600868.001).
  • [ISSN] 1107-0625
  • [Journal-full-title] Journal of B.U.ON. : official journal of the Balkan Union of Oncology
  • [ISO-abbreviation] J BUON
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Greece
  • [Number-of-references] 65
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18. Tajima Y, Ishibashi K, Gonda T, Miyazaki T, Nakada H, Takahashi T, Ishida H: [Squamous cell carcinoma of the anal canal showing complete response following chemoradiotherapy--a case report]. Gan To Kagaku Ryoho; 2007 Nov;34(12):2050-2
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  • [Title] [Squamous cell carcinoma of the anal canal showing complete response following chemoradiotherapy--a case report].
  • We report a case of squamous cell carcinoma of the anal canal which showed complete response following chemoradiotherapy.
  • A 54-year-old woman was diagnosed as having squamous cell carcinoma of the anal canal (T2N0M0 stage II).
  • Chemoradiotherapy comprising peroral tegafur/uracil and external radiotherapy (60 Gy) to the pelvic space resulted in complete response 4 months after the initiation of the treatment.
  • PET-CT showed recurrence in paraortic lymph node, right sacral and left pubic bone 11 months after the initiation of treatment, although the primary lesion did not relapse.
  • The patient is now given 5-fluorouracil/cisplatin in addition to external radiotherapy (57.5 Gy) to the metastatic lymph node.
  • This case suggests that we should take measures to prevent distant metastases in the treatment of squamous cell carcinoma of the anal canal.
  • [MeSH-major] Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Colonoscopy. Female. Humans. Magnetic Resonance Imaging. Middle Aged. Neoplasm Metastasis / drug therapy. Neoplasm Metastasis / pathology. Neoplasm Metastasis / radiotherapy

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  • (PMID = 18219895.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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19. Kuga Y, Tanaka T, Arita M, Usui Y, Okanobu H, Numata Y, Miwata T, Yoshimi S, Murakami E, Moriya T, Ohya T, Nishida T: [A case of effective chemoradiotherapy using S-1 and CDDP for left inguinal lymph node metastasis of anal canal carcinoma]. Gan To Kagaku Ryoho; 2009 Nov;36(11):1923-5
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  • [Title] [A case of effective chemoradiotherapy using S-1 and CDDP for left inguinal lymph node metastasis of anal canal carcinoma].
  • We report a case of left inguinal lymph node metastasis of anal canal carcinoma, treated effectively with chemotherapy consisting of S-1 and CDDP combined with radiotherapy.
  • In February 2006, a 76-year-old woman underwent resection of a tumor diagnosed as squamous cell carcinoma of the anal canal.
  • The patient refused additional surgical therapy.
  • Biopsy was performed, and specimens were shown to include squamous cell carcinoma cells.
  • The patient was treated using chemotherapy concurrent with radiotherapy.
  • The chemotherapy consisted of oral S-1 (80 mg/body/day; 5 days/week) and intravenous CDDP (5 mg/body/day; 5 days/week), both administered for 4 weeks.
  • Radiotherapy at 2 Gy/day was administered 25 times (total dose 50 Gy).
  • The metastatic tumor in the lymph node responded well to the treatment and decreased remarkably in size by December 2007.
  • After chemoradiotherapy, the oral administration of S-1 alone (80 mg/body) for 2 weeks followed by a 2-week rest period as one course was continued for 1 year.
  • The lymph node metastasis had disappeared 1 year after chemoradiotherapy, as determined by computed tomography (CT) and positron emission tomography-CT, representing a complete response.
  • Chemotherapy consisting of S-1 and CDDP concurrent with radiotherapy maybe effective for treating metastatic lymph node metastasis of anal canal carcinoma.
  • [MeSH-major] Anal Canal. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / pathology. Carcinoma, Squamous Cell / pathology. Lymphatic Metastasis
  • [MeSH-minor] Administration, Oral. Aged. Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Agents / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Drug Combinations. Female. Humans. Inguinal Canal. Injections, Intravenous. Oxonic Acid / administration & dosage. Radiotherapy Dosage. Tegafur / administration & dosage

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  • (PMID = 19920402.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 0 / Drug Combinations; 150863-82-4 / S 1 (combination); 1548R74NSZ / Tegafur; 5VT6420TIG / Oxonic Acid; Q20Q21Q62J / Cisplatin
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20. Tristram A, Fiander A: Clinical responses to Cidofovir applied topically to women with high grade vulval intraepithelial neoplasia. Gynecol Oncol; 2005 Dec;99(3):652-5
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  • RESULTS: 12 women with high grade vulval, vaginal or perianal intraepithelial neoplasia were recruited, 10 of whom completed follow up.
  • Diseased tissue underwent ulceration in the majority of cases, with no effect seen on neighbouring normal skin.
  • CONCLUSION: These complete responses, in women with long standing disease, together with preservation of normal tissue, suggest that topical treatment with Cidofovir may have a place in the therapeutic armamentarium of high grade vulval intraepithelial neoplasia.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Carcinoma in Situ / drug therapy. Cytosine / analogs & derivatives. Organophosphonates / administration & dosage. Vulvar Neoplasms / drug therapy
  • [MeSH-minor] Administration, Topical. Adult. Aged. Female. Humans. Middle Aged. Neoplasm Recurrence, Local / drug therapy

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  • (PMID = 16169066.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Organophosphonates; 8J337D1HZY / Cytosine; JIL713Q00N / cidofovir
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21. Bruland O, Fluge O, Immervoll H, Balteskard L, Myklebust M, Skarstein A, Dahl O: Gene expression reveals two distinct groups of anal carcinomas with clinical implications. Br J Cancer; 2008 Apr 8;98(7):1264-73
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  • [Title] Gene expression reveals two distinct groups of anal carcinomas with clinical implications.
  • Human papillomavirus (HPV) is a major aetiological agent in anal carcinomas.
  • We here present a study of global gene expression using microarray hybridisation in a collection of anal carcinoma biopsies.
  • To investigate whether this distinction in gene expression had prognostic impact, we studied protein expression in an independent cohort of 55 anal carcinomas not included in the microarray study of two differentially expressed candidate genes, minichromosome maintenance complex component 7 (MCM7) and cyclin-dependent kinase inhibitor 2A (CDKN2A or p16).
  • High level of MCM7 protein was found to be associated with both improved relapse-free survival (RFS, P=0.02) and cancer-specific survival (CSS, P=0.03) in anal cancer patients treated with radiation with or without additional chemotherapy.
  • [MeSH-minor] Cell Cycle Proteins / analysis. DNA-Binding Proteins / analysis. Gene Expression. Genes, p16. Humans. In Situ Hybridization. Minichromosome Maintenance Complex Component 7. Nuclear Proteins / analysis. Oligonucleotide Array Sequence Analysis. Oncogene Proteins, Viral / analysis. Papillomavirus E7 Proteins. Protein Array Analysis. RNA, Messenger / analysis. Viral Load

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  • (PMID = 18349847.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Cell Cycle Proteins; 0 / DNA-Binding Proteins; 0 / Nuclear Proteins; 0 / Oncogene Proteins, Viral; 0 / Papillomavirus E7 Proteins; 0 / RNA, Messenger; 0 / oncogene protein E7, Human papillomavirus type 16; EC 3.6.4.12 / MCM7 protein, human; EC 3.6.4.12 / Minichromosome Maintenance Complex Component 7
  • [Other-IDs] NLM/ PMC2359638
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22. Kim JH, Sarani B, Orkin BA, Young HA, White J, Tannebaum I, Stein S, Bennett B: HIV-positive patients with anal carcinoma have poorer treatment tolerance and outcome than HIV-negative patients. Dis Colon Rectum; 2001 Oct;44(10):1496-502
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] HIV-positive patients with anal carcinoma have poorer treatment tolerance and outcome than HIV-negative patients.
  • PURPOSE: Anal carcinoma is being found in HIV-positive patients with increasing frequency.
  • Most patients are treated with combined chemotherapy and radiation.
  • It was our impression that HIV-positive patients do not fare as well as HIV-negative patients in terms of both response to and tolerance of therapy.
  • METHODS: To test this hypothesis, we reviewed our experience with anal carcinoma and compared HIV-positive to HIV-negative patients by age, gender, sexual orientation, stage at diagnosis, treatment rendered, response to treatment, tolerance, and survival.
  • From 1985 to 1998, 98 patients with anal neoplasms were treated.
  • Seventy-three patients had invasive squamous-cell carcinoma (including cloacogenic carcinoma), and this cohort was analyzed.
  • Acute treatment major toxicity differed significantly (HIV positive 80 percent vs. HIV negative 30 percent; P < 0.005).
  • Only 62 percent of HIV-positive patients were rendered disease free after initial therapy vs. 85 percent of HIV-negative patients (P = 0.11).
  • Median time to cancer-related death was 1.4 vs. 5.3 years (P < 0.05).
  • A survival model did not show age, gender, stage, or treatment to be independent predictors.
  • CONCLUSION: We found that HIV-positive patients with anal carcinoma seem to be a different population from HIV-negative patients by age, gender, and sexual orientation.
  • They have a poorer tolerance for combined therapy and a shorter time to cancer-related death.
  • These results suggest that the treatment of HIV-positive patients with anal carcinoma needs to be reassessed.
  • [MeSH-major] Anus Neoplasms / complications. Anus Neoplasms / therapy. HIV Infections / complications
  • [MeSH-minor] Adult. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Prognosis. Radiotherapy Dosage. Treatment Outcome

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  • (PMID = 11598480.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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23. Amano K, Ishibashi K, Nakada H, Okada N, Miyazaki T, Gonda T, Ishida H, Takahashi T: [Squamous cell carcinoma of the anal canal in the elderly showing complete response following radiotherapy--a case report]. Gan To Kagaku Ryoho; 2007 Nov;34(12):2025-8
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  • [Title] [Squamous cell carcinoma of the anal canal in the elderly showing complete response following radiotherapy--a case report].
  • We reported an elderly case of squamous cell carcinoma of the anal canal which showed complete response following radiotherapy alone.
  • An 86-year-old man complaining of anal bleeding and pain was admitted.
  • Colonoscopy showed a type 1 tumor just above the dentate line.
  • Biopsy revealed squamous cell carcinoma.
  • Serum SCC Level before treatment was elevated (8.4 ng/mL).
  • Since the patient and his family members refused a surgical intervension and chemotherapy, he received an external radiotherapy (total dose: 60 Gy) to the pelvic space and showed complete response after radiotherapy.
  • [MeSH-major] Anus Neoplasms / pathology. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Aged, 80 and over. Biomarkers, Tumor / blood. Colonoscopy. Humans. Magnetic Resonance Imaging. Male. Tomography, X-Ray Computed

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  • (PMID = 18219887.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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24. Capdevila J, Ramos FJ, Macarulla T, Elez E, Ruiz-Echarri M, Perez-Garcia J, Tabernero J: Development of new drug strategies in infrequent digestive tumors: esophageal, biliary tract, and anal cancers. Curr Opin Oncol; 2009 Jul;21(4):374-80
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  • [Title] Development of new drug strategies in infrequent digestive tumors: esophageal, biliary tract, and anal cancers.
  • PURPOSE OF REVIEW: In the last years, interesting advances have been reported in the treatment of infrequent digestive tumors.
  • The increasing development of new targeted therapies in human cancer has also impacted in these rare gastrointestinal malignancies providing a wide range of possibilities in the design of future clinical trials.
  • Additionally, several targeted therapies have been developed to target the main kinase proteins of the most important pathways of these malignancies.
  • The results of the biggest phase III trial in locally advanced anal carcinoma have been recently published.
  • Finally, the inhibition of epidermal growth factor receptor has also showed promising activity in anal carcinomas.
  • Although the major advances in targeted therapy have been introduced in the treatment of colorectal cancer, new interesting approaches have been reported in less frequent gastrointestinal tumors such as esophageal, biliary tract, and anal canal carcinoma opening a new hope in the treatment of these rare tumors in the molecular targeted therapy era.
  • [MeSH-major] Digestive System Neoplasms / drug therapy
  • [MeSH-minor] Angiogenesis Inhibitors / therapeutic use. Anus Neoplasms / blood supply. Anus Neoplasms / drug therapy. Anus Neoplasms / enzymology. Biliary Tract Neoplasms / blood supply. Biliary Tract Neoplasms / drug therapy. Biliary Tract Neoplasms / enzymology. Drug Delivery Systems. Esophageal Neoplasms / blood supply. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / enzymology. Humans. Neovascularization, Pathologic / drug therapy. Receptor, Epidermal Growth Factor / antagonists & inhibitors

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  • (PMID = 19412097.001).
  • [ISSN] 1531-703X
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; EC 2.7.10.1 / Receptor, Epidermal Growth Factor
  • [Number-of-references] 65
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25. van der Wal BC, Cleffken BI, Gulec B, Kaufman HS, Choti MA: Results of salvage abdominoperineal resection for recurrent anal carcinoma following combined chemoradiation therapy. J Gastrointest Surg; 2001 Jul-Aug;5(4):383-7
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  • [Title] Results of salvage abdominoperineal resection for recurrent anal carcinoma following combined chemoradiation therapy.
  • Combined chemotherapy and radiation therapy is the standard treatment for epidermoid carcinoma of the anal canal.
  • The aim of this study was to review our experience with abdominoperineal resection following failure of chemoradiation therapy for epidermoid carcinoma of the anus.
  • Between 1980 and 1998, 17 patients underwent salvage abdominoperineal resection following failure of chemoradiation therapy.
  • The median follow-up time for the patients operated on with curative intent was 53 months.
  • Potential prognostic factors that were not found to have an impact on survival included margin status of resection, sphincter invasion, and degree of differentiation.
  • Selected patients with recurrent or persistent anal carcinoma following chemoradiation therapy can be offered salvage abdominoperineal resection.
  • Prolonged survival can be achieved in some patients following salvage resection for epidermoid carcinoma of the anal canal.
  • [MeSH-major] Anus Neoplasms / surgery. Carcinoma, Squamous Cell / surgery. Neoplasm Recurrence, Local / surgery
  • [MeSH-minor] Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Middle Aged. Postoperative Complications / epidemiology. Reconstructive Surgical Procedures. Salvage Therapy. Surgical Flaps. Survival Analysis. Time Factors. Treatment Failure. Treatment Outcome

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  • [Cites] Dis Colon Rectum. 1992 Jun;35(6):574-7; discussion 577-8 [1587176.001]
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  • (PMID = 11985979.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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26. Diluvio L, Campione E, Paternò EJ, Orlandi A, Terrinoni A, Chimenti S: Peculiar clinical and dermoscopic remission pattern following imiquimod therapy of basal cell carcinoma in seborrhoeic areas of the face. J Dermatolog Treat; 2009;20(2):124-9
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  • [Title] Peculiar clinical and dermoscopic remission pattern following imiquimod therapy of basal cell carcinoma in seborrhoeic areas of the face.
  • Imiquimod is a 240.3-Da synthetic imidazoquinolinamine (C14H16N4), developed in 1983 and approved in 1997 by the US Food and Drug Administration for the topical treatment of external genital and perianal warts and, more recently, also for actinic keratosis and superficial basal cell carcinomas.
  • We report five cases of patients affected by basal cell carcinomas localized in seborrhoeic areas of the face, successfully treated with topical imiquimod and characterized by the occurrence of eruptive epidermoid cysts at the end-point of therapy.
  • The dermatoscopic evaluation disclosed the presence in all lesions of a common feature characterized by a hyperkeratotic yellow-withish area, resembling 'popcorn', excluding dermoscopic basal cell carcinoma features.
  • As reported in the literature and as observed in our clinical experience, the occurrence of epidermoid cysts, after the topical treatment of basal cell carcinomas with imiquimod, may represent a local immune reaction that is drug-related and is a typical remission pattern in particular anatomical areas.
  • In the future, it will be possible to follow-up the lesions after treatment avoiding the post-control biopsy punch.
  • [MeSH-major] Aminoquinolines / therapeutic use. Carcinoma, Basal Cell / drug therapy. Carcinoma, Basal Cell / pathology. Skin Neoplasms / drug therapy. Skin Neoplasms / pathology
  • [MeSH-minor] Administration, Cutaneous. Aged. Antineoplastic Agents / therapeutic use. Biopsy, Needle. Dermoscopy / methods. Dose-Response Relationship, Drug. Drug Administration Schedule. Face. Female. Follow-Up Studies. Humans. Immunohistochemistry. Male. Middle Aged. Neoplasm Staging. Risk Assessment. Sampling Studies. Treatment Outcome

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  • (PMID = 18991155.001).
  • [ISSN] 1471-1753
  • [Journal-full-title] The Journal of dermatological treatment
  • [ISO-abbreviation] J Dermatolog Treat
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Antineoplastic Agents; 99011-02-6 / imiquimod
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27. Devon KM, Brown CJ, Burnstein M, McLeod RS: Cancer of the anus complicating perianal Crohn's disease. Dis Colon Rectum; 2009 Feb;52(2):211-6
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  • [Title] Cancer of the anus complicating perianal Crohn's disease.
  • PURPOSE: This study was designed to review the clinical and pathologic findings, treatment, and outcomes of patients who have a cancer that complicates perianal Crohn's disease.
  • METHODS: Charts of patients who had documented perianal Crohn's disease and a pathologic diagnosis of anal carcinoma were reviewed.
  • RESULTS: There were 14 patients (6 men; mean age, 49 years) who had evidence of perianal Crohn's disease (mean, 6.9 (range, 1-20) years) before their cancer diagnosis.
  • Ten patients had preoperative diagnoses of cancer; however, none of the eight magnetic resonance imaging studies were diagnostic.
  • There were 11 adenocarcinomas (8 mucinous or colloid subtypes) and 3 squamous-cell carcinomas.
  • Treatment included abdominoperineal resections plus chemotherapy in 12, and radiation and a defunctioning stoma in 1 patient.
  • CONCLUSIONS: Physicians should have a high level of suspicion of cancer in patients with longstanding perianal Crohn's disease who have a change in symptoms.
  • In this series, patients who were diagnosed preoperatively and treated with multimodality therapy had better outcomes.
  • [MeSH-minor] Adenocarcinoma / complications. Adenocarcinoma / diagnosis. Adult. Aged. Anal Canal / pathology. Anus Diseases / complications. Anus Diseases / pathology. Carcinoma, Squamous Cell / complications. Carcinoma, Squamous Cell / diagnosis. Female. Humans. Male. Middle Aged

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  • (PMID = 19279414.001).
  • [ISSN] 1530-0358
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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28. Swann MH, Yoon J: Merkel cell carcinoma. Semin Oncol; 2007 Feb;34(1):51-6
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  • [Title] Merkel cell carcinoma.
  • Merkel cell carcinoma (MCC) is a rare, aggressive cutaneous cancer that predominately affects elderly Caucasians with fair skin and has a propensity for local recurrence and regional lymph node metastases.
  • A variety of terms have been used to describe this tumor, including trabecular cell carcinoma, neuroendocrine or primary small cell carcinoma of the skin, and anaplastic cancer of the skin.
  • Although the skin lesion is most commonly found on sun-exposed areas of the head and neck or extremities, it can occur on the trunk, genitalia, and perianal region.
  • It may be difficult to accurately diagnose MCC by light microscopy alone and ancillary techniques, including electron microscopy and immunohistochemistry, may be necessary to make a definitive diagnosis.
  • Nonetheless, for localized disease most guidelines include wide local excision of the primary tumor either alone or with radiation therapy.
  • Systemic chemotherapy, akin to regimens for small cell carcinoma of the lung, may be considered as an adjuvant following surgery or to treat locoregional or distant disease.
  • [MeSH-major] Carcinoma, Merkel Cell. Skin Neoplasms
  • [MeSH-minor] Aged. Combined Modality Therapy. Humans. Lymphatic Metastasis. Neoplasm Recurrence, Local / diagnosis. Prognosis. Treatment Outcome

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  • (PMID = 17270666.001).
  • [ISSN] 0093-7754
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 48
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29. Preti M, Micheletti L, Ghiringhello B, Privitera S, Condello V, Chieppa P, Massobrio M: [Vulvar Paget's disease. Clinico-pathologic review of the literature]. Minerva Ginecol; 2000 May;52(5):203-11
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  • [Transliterated title] La malattia di Paget vulvare. Revisione clinico-patologica della letteratura.
  • In 1986 the International Society For the Study of Vulvar Disease classified vulvar Paget's disease (VPD) as a non-squamous intraepithelial lesion of the vulva.
  • Patients with VPD are at risk for a second synchronous or metachronous neoplasia: colo-rectal adenocarcinoma (more frequent in perianal localization of VPD), cervical adenocarcinoma, carcinoma of the transitional epithelium from the renal pelvis to urethra and mammary carcinoma.
  • Therapy for intraepithelial VPD is wide and deep surgical resection comprising all the skin appendages.
  • The role of chemotherapy and radiotherapy in the multimodal approach to extensive or recurring VPD is still controversial.

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  • (PMID = 11048477.001).
  • [ISSN] 0026-4784
  • [Journal-full-title] Minerva ginecologica
  • [ISO-abbreviation] Minerva Ginecol
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] ITALY
  • [Number-of-references] 69
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30. De Dosso S, Martin V, Zanellato E, Frattini M, Saletti P: Molecular characterization and response to cetuximab in a patient with refractory squamous cell anal carcinoma. Tumori; 2010 Jul-Aug;96(4):627-8
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  • [Title] Molecular characterization and response to cetuximab in a patient with refractory squamous cell anal carcinoma.
  • There are no standard chemotherapeutic options for patients with squamous cell anal carcinoma, relapsing and progressing on palliative cisplatin-based regimens.
  • Similarly to other malignant conditions, monoclonal antibodies directed against the epidermal growth factor receptor may represent an attractive therapeutic strategy.
  • [MeSH-major] Antibodies, Monoclonal / pharmacology. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Carcinoma, Squamous Cell / drug therapy. Receptor, Epidermal Growth Factor / antagonists & inhibitors
  • [MeSH-minor] Aged. Antibodies, Monoclonal, Humanized. Camptothecin / administration & dosage. Camptothecin / analogs & derivatives. Cetuximab. Disease Progression. Humans. Male. Neoplasm Recurrence, Local / drug therapy. Treatment Outcome

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  • (PMID = 20968146.001).
  • [ISSN] 0300-8916
  • [Journal-full-title] Tumori
  • [ISO-abbreviation] Tumori
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 7673326042 / irinotecan; EC 2.7.10.1 / Receptor, Epidermal Growth Factor; PQX0D8J21J / Cetuximab; XT3Z54Z28A / Camptothecin
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31. Zampino MG, Magni E, Sonzogni A, Renne G: K-ras status in squamous cell anal carcinoma (SCC): it's time for target-oriented treatment? Cancer Chemother Pharmacol; 2009 Dec;65(1):197-9
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  • [Title] K-ras status in squamous cell anal carcinoma (SCC): it's time for target-oriented treatment?
  • PURPOSE: Squamous cell anal carcinoma (SCC) is an uncommon disease comprising only 1-5% of all intestinal tumours.
  • SCC is now considered the prototype for the successful application of conservative treatment as chemoradiation instead of aggressive surgery.
  • The EGFR status and k-ras mutations in SCC of the anal canal has not been well investigated.
  • METHODS: From June 1999 to December 2008, 32 patients affected by SCC were treated in our institution with chemotherapy containing Fluoropyrimidine and platinum salt concomitant with pelvic radiotherapy.
  • In all cases of our series wild-type K-ras was observed.
  • This observation could support the role of EGFR-inhibitors in the treatment of SCC.
  • [MeSH-major] Anus Neoplasms / genetics. Carcinoma, Squamous Cell / genetics. Proto-Oncogene Proteins / genetics. Receptor, Epidermal Growth Factor / genetics. ras Proteins / genetics
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Drug Delivery Systems. Female. Humans. Immunohistochemistry. Male. Middle Aged. Mutation. Retrospective Studies


32. Tyring S, Conant M, Marini M, Van Der Meijden W, Washenik K: Imiquimod; an international update on therapeutic uses in dermatology. Int J Dermatol; 2002 Nov;41(11):810-6
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  • [Title] Imiquimod; an international update on therapeutic uses in dermatology.
  • Imiquimod, the first member of a new class of immune response modifiers, is approved for the treatment of external genital and perianal warts.
  • This is the initial event in an immunological cascade resulting in the stimulation of the innate immune response as well as the cell-mediated pathway of acquired immunity.
  • These properties highlight the potential of imiquimod not only as an effective treatment for genital warts, but also as a treatment for other cutaneous viral infections and cutaneous neoplasms.
  • [MeSH-major] Adjuvants, Immunologic / therapeutic use. Aminoquinolines / therapeutic use. Dermatologic Agents / therapeutic use
  • [MeSH-minor] Carcinoma / drug therapy. Condylomata Acuminata / drug therapy. DNA Virus Infections / drug therapy. Humans. Immunocompromised Host. Papillomaviridae. Papillomavirus Infections / drug therapy. Skin Neoplasms / drug therapy

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  • (PMID = 12453012.001).
  • [ISSN] 0011-9059
  • [Journal-full-title] International journal of dermatology
  • [ISO-abbreviation] Int. J. Dermatol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / Aminoquinolines; 0 / Dermatologic Agents; 99011-02-6 / imiquimod
  • [Number-of-references] 55
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33. Yeh KY, Dunn P, Chang JW, Liaw CC: Microangiopathic hemolytic anemia in a patient with recurrent anal cancer and liver metastasis. Chang Gung Med J; 2002 Oct;25(10):706-10
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  • [Title] Microangiopathic hemolytic anemia in a patient with recurrent anal cancer and liver metastasis.
  • Microangiopathic hemolytic anemia (MAHA) is a late but fatal complication in advanced cancers (cancer-associated).
  • It may also appear in complete remission after chemotherapy (chemotherapy-related).
  • Squamous cell carcinoma with MAHA, on the other hand, has not often been reported in the English literature.
  • Because of the difficulty of case collection, understanding of the association of MAHA and anal squamous cell carcinoma remains vague.
  • We present a 60-year-old woman with anal cancer and liver metastasis.
  • This patient received chemotherapy (mitomycin C, 5-fluoruracil, and cisplatin) and reached a good partial response.
  • MAHA developed 2 months later, and tumor recurrence with rapid deterioration appeared 5 months later.
  • We consider that the MAHA in this patient is chemotherapy-related.
  • However, the possibility of cancer-associated MAHA could not be excluded.
  • [MeSH-major] Anemia, Hemolytic / etiology. Anus Neoplasms / complications. Carcinoma, Squamous Cell / complications. Liver Neoplasms / secondary. Neoplasm Recurrence, Local / complications
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Female. Humans. Middle Aged


34. Giovannini M, Bardou VJ, Barclay R, Palazzo L, Roseau G, Helbert T, Burtin P, Bouché O, Pujol B, Favre O: Anal carcinoma: prognostic value of endorectal ultrasound (ERUS). Results of a prospective multicenter study. Endoscopy; 2001 Mar;33(3):231-6
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  • [Title] Anal carcinoma: prognostic value of endorectal ultrasound (ERUS). Results of a prospective multicenter study.
  • BACKGROUND AND STUDY AIMS: The classification of anal carcinoma is based on the clinical examination and the estimation of the tumor height (Union Internationale Contre le Cancer (UICC) 1987 Classification).
  • This classification has a direct therapeutic application since tumors which are designated T1 and T2 are generally treated by radiotherapy whereas T3, T4 or N+ lesions are treated by concomitant radiation and chemotherapy.
  • The ERUS classification incorporates disease of the anal canal and the perirectal lymph nodes, thus: usT1 describes involvement of the mucosa and submucosa with sparing of the internal sphincter; usT2, involvement of the internal sphincter with sparing of the external sphincter; usT3, involvement of the external sphincter; usT4, involvement of a pelvic organ; N0 describes no suspicious perirectal lymph nodes, and N+, perirectal lymph nodes fulfilling endosonographic criteria for malignancy (e.g. round, hypoechoic).
  • RESULTS: Data concerning the treatment and follow-up were available for 115/146 patients (78.7%).
  • We compared the prognostic importance of the two classification schemes for treatment response and the rate of local relapse (chi-squared test).
  • A significantly greater proportion of T1-T2N0 lesions classified by ERUS had a complete response to treatment than those classified by conventional UICC staging (94.5% vs. 80%, respectively; P = 0.008).
  • [MeSH-major] Anus Neoplasms / ultrasonography. Carcinoma, Squamous Cell / ultrasonography. Endosonography

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  • (PMID = 11293755.001).
  • [ISSN] 0013-726X
  • [Journal-full-title] Endoscopy
  • [ISO-abbreviation] Endoscopy
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] Germany
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35. Chapet O, Gerard JP, Mornex F, Goncalves-Tavan S, Ardiet JM, D'hombres A, Favrel V, Romestaing P: Prognostic factors of squamous cell carcinoma of the anal margin treated by radiotherapy: the Lyon experience. Int J Colorectal Dis; 2007 Feb;22(2):191-9
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  • [Title] Prognostic factors of squamous cell carcinoma of the anal margin treated by radiotherapy: the Lyon experience.
  • BACKGROUND: To report our patient experience with squamous cell carcinoma of the anal margin and to evaluate the prognostic factors influencing outcome.
  • MATERIALS AND METHODS: Between 1980 and 2001, 26 patients with anal margin squamous cell carcinoma were treated in Lyon-Sud: 7 T1, 14 T2, 4 T3, and 1 T4 with 20 N0, 3 N1, and 3 N2.
  • The anal canal was invaded in five patients.
  • Treatment consisted of definitive external irradiation in 14 patients and adjuvant irradiation (after a local excision) in 12 patients.
  • External irradiation was combined with chemotherapy in seven patients, brachytherapy in four patients, and both brachytherapy and chemotherapy in one patient.
  • RESULTS: The local control rate was initially 61.4%, and it was 80.8% after salvage treatment.
  • Three factors correlated with specific survival: cell differentiation (P=0.038) and T (P=0.001) and N category (P=0.0005).
  • CONCLUSION: Our results confirm the dominating place of definitive irradiation and radiochemotherapy in the treatment of anal margin squamous cell carcinoma.
  • The prognosis of squamous cell carcinoma is correlated to T and N staging and cell differentiation.
  • [MeSH-major] Anus Neoplasms / radiotherapy. Neoplasms, Squamous Cell / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Colectomy. Combined Modality Therapy. Female. France. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Treatment Outcome

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  • (PMID = 16799791.001).
  • [ISSN] 0179-1958
  • [Journal-full-title] International journal of colorectal disease
  • [ISO-abbreviation] Int J Colorectal Dis
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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36. Wright JL, Patil SM, Temple LK, Minsky BD, Saltz LB, Goodman KA: Squamous cell carcinoma of the anal canal: patterns and predictors of failure and implications for intensity-modulated radiation treatment planning. Int J Radiat Oncol Biol Phys; 2010 Nov 15;78(4):1064-72
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  • [Title] Squamous cell carcinoma of the anal canal: patterns and predictors of failure and implications for intensity-modulated radiation treatment planning.
  • PURPOSE: Intensity-modulated radiation treatment (IMRT) is increasingly used in the treatment of squamous cell carcinoma of the anal canal (SCCAC).
  • To better define the CTV for IMRT, we evaluated patterns and predictors of LRF in SCCAC patients given conventional radiation treatment.
  • METHODS AND MATERIALS: We reviewed records of 180 SCCAC patients treated with conventional radiation with or without chemotherapy at our institution between January 1990 and March 2007.
  • All patients received radiation; the median primary tumor dose was 45 Gy.
  • A total of 173 patients also received mitomycin-based chemotherapy.
  • Cumulative sites of LRF (patients may have one or more site of failure) were as follows: primary, 35; inguinal, 8; external perianal, 5; common iliac, 4; presacral, 3; distal rectum, 2; external iliac, 2; and internal iliac, 2.
  • [MeSH-major] Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / radiotherapy. Radiotherapy Planning, Computer-Assisted / methods. Radiotherapy, Intensity-Modulated / methods. Tumor Burden
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Female. Fluorouracil / administration & dosage. Humans. Lymphatic Irradiation. Lymphatic Metastasis. Male. Middle Aged. Mitomycin / administration & dosage. Neoplasm Recurrence, Local / prevention & control. Neoplasm Staging. Radiotherapy Dosage. Treatment Failure

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  • [Copyright] Copyright © 2010 Elsevier Inc. All rights reserved.
  • (PMID = 20350793.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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37. Bieri S, Allal AS, Kurtz JM: Sphincter-conserving treatment of carcinomas of the anal margin. Acta Oncol; 2001;40(1):29-33
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  • [Title] Sphincter-conserving treatment of carcinomas of the anal margin.
  • Between April 1982 and December 1997 24 patients with carcinoma of the anal margin were treated with radiation therapy (RT) (10 patients) or RT-chemotherapy (CT) (14 patients).
  • Chemotherapy was based on 5-fluorouracil and mitomycin-C.
  • Anal sphincter was preserved in 16/24 treated patients.
  • Major late toxicity is uncommon; a better adaptation of treatment technique to the individual clinical situation may prevent some of the more severe complications in the future.
  • [MeSH-major] Anal Canal / radiation effects. Anus Neoplasms / radiotherapy. Carcinoma / radiotherapy
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Retrospective Studies. Survival Rate

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  • (PMID = 11321656.001).
  • [ISSN] 0284-186X
  • [Journal-full-title] Acta oncologica (Stockholm, Sweden)
  • [ISO-abbreviation] Acta Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Norway
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38. Wenzel J, Uerlich M, Haller O, Bieber T, Tueting T: Enhanced type I interferon signaling and recruitment of chemokine receptor CXCR3-expressing lymphocytes into the skin following treatment with the TLR7-agonist imiquimod. J Cutan Pathol; 2005 Apr;32(4):257-62
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  • [Title] Enhanced type I interferon signaling and recruitment of chemokine receptor CXCR3-expressing lymphocytes into the skin following treatment with the TLR7-agonist imiquimod.
  • INTRODUCTION: Imiquimod (Aldara) is an immune response modifier approved for the topical treatment of external genital and perianal warts which can mediate regression of several cutaneous malignancies [basal cell carcinoma (BCC), Bowen's disease, actinic keratosis, and metastasis of malignant melanoma].
  • PATIENTS AND METHODS: In the present study we analyzed the expression of MxA, a protein specifically induced by type I IFNs during topical imiquimod treatment in several patients suffering from different cutaneous malignancies (BCC, cutaneous metastasis of melanoma, and breast cancer), and characterized the inflammatory infiltrate, along with the expression of chemokine receptor CXCR3, by immunohistochemistry.
  • RESULTS: Treatment with the TLR7-agonist imiquimod induced a significant lesional lymphocytic inflammation, associated with strong expression of MxA, indicating the induction of type I IFN signaling.
  • DISCUSSION: Our in vivo results suggest an important role for TLR7-induced production of type I IFN, which links innate and adaptive immunity and promotes specific Th1-biased cellular immune response capable of eliminating cutaneous malignancies.
  • MxA appears to be a valuable parameter to demonstrate IFN-type I expression in imiquimod therapy.
  • [MeSH-major] Adjuvants, Immunologic / therapeutic use. Aminoquinolines / therapeutic use. Interferon Type I / immunology. Lymphocytes / immunology. Membrane Glycoproteins / agonists. Receptors, Cell Surface / agonists. Receptors, Chemokine / immunology. Skin / immunology
  • [MeSH-minor] Breast Neoplasms / immunology. Breast Neoplasms / secondary. Carcinoma, Basal Cell / immunology. Carcinoma, Basal Cell / secondary. Chemotaxis, Leukocyte / drug effects. Chemotaxis, Leukocyte / immunology. Female. Humans. Melanoma / immunology. Melanoma / secondary. Receptors, CXCR3. Signal Transduction. Skin Neoplasms / drug therapy. Skin Neoplasms / secondary. Toll-Like Receptor 7. Toll-Like Receptors

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  • (PMID = 15769273.001).
  • [ISSN] 0303-6987
  • [Journal-full-title] Journal of cutaneous pathology
  • [ISO-abbreviation] J. Cutan. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / Aminoquinolines; 0 / CXCR3 protein, human; 0 / Interferon Type I; 0 / Membrane Glycoproteins; 0 / Receptors, CXCR3; 0 / Receptors, Cell Surface; 0 / Receptors, Chemokine; 0 / TLR7 protein, human; 0 / Toll-Like Receptor 7; 0 / Toll-Like Receptors; 99011-02-6 / imiquimod
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39. Peiffert D: [Rationale and progress of the phase III trial: intensification of the treatment of locally advanced squamous cell carcinoma of the anal canal]. Cancer Radiother; 2003 Nov;7 Suppl 1:100s-107s
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  • [Title] [Rationale and progress of the phase III trial: intensification of the treatment of locally advanced squamous cell carcinoma of the anal canal].
  • [Transliterated title] Rationnel et déroulement de l'essai de phase III: intensification thérapeutique des cancers épidermoïdes du canal anal localement évolués (FNCLCC/ACCORD 03, FFCD/9802, SFRO).
  • Concomitant radiotherapy (5FU-MMC) was proved to be useful in locally advanced anal canal carcinoma.
  • Nevertheless, it remains 30% of failures after this conservative treatment.
  • The tolerance and efficiency of a neoadjuvant chemotherapy (5-FU-CDDP) were validated by a phase II trial including 80 patients, which obtained 73% of colostomy free survival and 70% of relapse free survival at 3-year follow-up.
  • Its usefulness is studied in an ongoing phase III trial, as well as the dose escalation of the boost, from 15 Gy to 25-25 Gy.
  • [MeSH-major] Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Aged. Aged, 80 and over. Antibiotics, Antineoplastic / administration & dosage. Antibiotics, Antineoplastic / therapeutic use. Antimetabolites, Antineoplastic / administration & dosage. Antimetabolites, Antineoplastic / therapeutic use. Antineoplastic Agents / administration & dosage. Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brachytherapy. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cisplatin / therapeutic use. Clinical Trials, Phase II as Topic. Colostomy. Combined Modality Therapy. Fluorouracil / administration & dosage. Fluorouracil / therapeutic use. Follow-Up Studies. Humans. Lymphatic Metastasis. Mitomycin / administration & dosage. Mitomycin / therapeutic use. Multicenter Studies as Topic. Neoplasm Recurrence, Local. Prognosis. Radiotherapy Dosage. Randomized Controlled Trials as Topic. Survival Analysis. Time Factors

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  • (PMID = 15124551.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Comparative Study; English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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40. Arikawa S, Uchida M, Ogoh E, Uozumi J, Yoshida S, Watanabe Y, Kaida H, Ishibashi N, Shirouzu K, Hayabuchi N: [Drug eruption (erythema multiforme type) following chemoradiotherapy with mitomycin C and 5-fluorouracil administration for squamous cell carcinoma of the anal canal]. Gan To Kagaku Ryoho; 2010 Apr;37(4):727-30
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  • [Title] [Drug eruption (erythema multiforme type) following chemoradiotherapy with mitomycin C and 5-fluorouracil administration for squamous cell carcinoma of the anal canal].
  • We report a case of drug eruption (erythema multiforme type) in a 54-year-old woman, following concurrent chemoradiotherapy for squamous cell carcinoma of the anal canal.
  • Chemotherapy comprised one cycle of mitomycin C 10 mg/m2/day (intravenous bolus injection)on day 1 and 5-fluorouracil(5-FU)1, 000 mg/m 2/day (continuous intravenous infusion) on days 1-4 of radiotherapy.
  • 5 Gy(total dose, 33 Gy).
  • From day 4 after chemoradiotherapy, erythema appeared proximal to the forearm site used for drug administration.
  • We suspected erythema multiforme based on the appearance of wheals and target lesions of the skin and a patient history of chemoradiotherapy.
  • Although we could not provide sufficient chemotherapy and radiation therapy due to severe side effects, squamous cell carcinoma of the anal canal responded extremely well with a marked decrease in complete response.
  • We surmise that the drug eruption was associated with 5-FU.
  • Concurrent chemoradiotherapy is safe and effective for squamous cell carcinoma of the anal canal, but care is required to prevent drug eruption during treatment.
  • [MeSH-major] Anal Canal / pathology. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Carcinoma, Squamous Cell / drug therapy. Erythema Multiforme / chemically induced. Fluorouracil / adverse effects. Mitomycin / therapeutic use. Rectal Neoplasms / drug therapy
  • [MeSH-minor] Combined Modality Therapy / adverse effects. Female. Humans. Middle Aged. Steroids / therapeutic use

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  • (PMID = 20414036.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Steroids; 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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41. Roth AD, Berney CR, Rohner S, Allal AS, Morel P, Marti MC, Aapro MS, Alberto P: Intra-arterial chemotherapy in locally advanced or recurrent carcinomas of the penis and anal canal: an active treatment modality with curative potential. Br J Cancer; 2000 Dec;83(12):1637-42
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  • [Title] Intra-arterial chemotherapy in locally advanced or recurrent carcinomas of the penis and anal canal: an active treatment modality with curative potential.
  • The prognosis of locally advanced or recurrent carcinomas of the penis (PE) and of the anal canal (AC) after conventional treatment is dismal.
  • We report 16 patients (eight with AC carcinomas and eight with PE cancers) treated by intra-arterial (IA) chemotherapy.
  • The chemotherapy was administered via a femoral IA catheter with its tip located above the aortic bifurcation, under the inferior mesenteric artery.
  • It consisted of eight push injections, given over a 48-h period, of the following drug combination: cisplatin 8.5 mg m(-2), 5-FU 275 mg m(-2), methotrexate 27.5 mg m(-2), mitomycin C 1.2 mg m(-2), and bleomycin 4 mg m(-2).
  • Leucovorin was given po, 4 x 15 mg day(-1), during the chemotherapy and for 3 days thereafter.
  • A total of 52 cycles of treatment were administered.
  • Among the complete responders, four are alive and disease-free 2-15 years after treatment.
  • Four patients developed grade III/IV haematological toxicity with three episodes of febrile neutropenia, one of them with a fatal outcome due to patient's failure to obtain medical attention at the onset of his fever, one a grade III mucositis of the glans, and four a grade III/IV cutaneous toxicity, the latter caused by the IA administration of bleomycin.
  • In conclusion, IA chemotherapy is effective and potentially curative in locoregionally advanced or recurrent carcinomas of the penis and of the anus.
  • Its contribution in the primary management of advanced penile or anal carcinoma should be prospectively investigated.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Anus Neoplasms / drug therapy. Penile Neoplasms / drug therapy
  • [MeSH-minor] Administration, Oral. Aged. Aged, 80 and over. Arteries. Bleomycin / administration & dosage. Bleomycin / adverse effects. Cisplatin / administration & dosage. Cisplatin / adverse effects. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Follow-Up Studies. Humans. Injections. Male. Methotrexate / administration & dosage. Methotrexate / adverse effects. Middle Aged. Mitomycin / administration & dosage. Mitomycin / adverse effects. Neoplasm Recurrence, Local. Neutropenia / chemically induced. Skin Diseases / chemically induced. Treatment Outcome

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  • [Copyright] Copyright 2000 Cancer Research Campaign.
  • (PMID = 11104558.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] SCOTLAND
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 11056-06-7 / Bleomycin; 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; YL5FZ2Y5U1 / Methotrexate
  • [Other-IDs] NLM/ PMC2363463
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42. Barriger RB, Calley C, Cárdenes HR: Treatment of anal carcinoma in immune-compromised patients. Clin Transl Oncol; 2009 Sep;11(9):609-14
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  • [Title] Treatment of anal carcinoma in immune-compromised patients.
  • This study was undertaken to evaluate local control (LC), overall survival (OS) and toxicity in immune-compromised patients with anal carcinoma treated with radiotherapy with or without chemotherapy.
  • METHODS: We identified 25 patients with anal carcinoma and human immunodeficiency virus (HIV) infection or history of solid-organ transplant on chronic medical immune-suppression.
  • Median radiation dose to the primary tumour was 50 Gy.
  • RESULTS: One-, 3- and 5-year LC without salvage therapy was 87%, 87% and 70% respectively.
  • One-, 3- and 5-year OS was 100% for treatment time (TT) <50 days and 57%, 38% and 0% for TT > or =50 days (p=0.0009).
  • All patients had acute grade 2-3 skin toxicity.
  • Late grade 3-4 skin, GI and GU toxicity occurred in 8%, 4% and 0%.
  • CONCLUSIONS: Most HIV-positive and organ transplant patients receiving radiotherapy with or without chemotherapy experience acute toxicity but few have chronic complications.
  • [MeSH-major] Anus Neoplasms / therapy. Carcinoma / therapy. Immunocompromised Host
  • [MeSH-minor] Adult. Colostomy / statistics & numerical data. Disease Progression. Female. Follow-Up Studies. HIV Seropositivity / complications. HIV Seropositivity / immunology. HIV-1 / immunology. Humans. Male. Middle Aged. Registries. Salvage Therapy. Survival Analysis. Transplantation

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  • (PMID = 19776001.001).
  • [ISSN] 1699-3055
  • [Journal-full-title] Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
  • [ISO-abbreviation] Clin Transl Oncol
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] Italy
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43. Danciu M, Ferariu D, Teleman S, Mihailovici MS: [Anal squamous cell carcinoma synchronous with rectal adenocarcinoma]. Rev Med Chir Soc Med Nat Iasi; 2004 Oct-Dec;108(4):797-9
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  • [Title] [Anal squamous cell carcinoma synchronous with rectal adenocarcinoma].
  • [Transliterated title] Carcinom scuamocelular anal sincron cu adenocarcinom de rect prezentare de caz.
  • Most often colorectal carcinoma occurs single; synchronous multiple carcinomas usually develop at widely disparate sites.
  • The rectoscopy examination revealed a fungating, bleeding tumor located 5 cm from anal verge.
  • Microscopical examination of the surgical specimens confirmed the presence of the adenocarcinoma adjacent to a squamous cell carcinoma, moderate differentiated, with reduced keratinization, infiltrative.
  • Also, 2 from the 7 lymph nodes presented squamous cell carcinoma metastases.
  • The most important differential diagnostic is a rectal adenosquamous carcinoma.
  • Prognostic depends on stage of the disease, generally being worse than of the corresponding adenocarcinoma, and can be improved by radio- and chemotherapy.
  • [MeSH-major] Adenocarcinoma. Anus Neoplasms. Carcinoma, Squamous Cell. Neoplasms, Multiple Primary. Rectal Neoplasms

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  • (PMID = 16004220.001).
  • [ISSN] 0048-7848
  • [Journal-full-title] Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
  • [ISO-abbreviation] Rev Med Chir Soc Med Nat Iasi
  • [Language] rum
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Romania
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44. Chie EK, Wu HG, Heo DS, Bang YJ, Kim NK, Ha SW: Neoadjuvant chemotherapy followed by radiotherapy in epidermoid carcinoma of anus. Tumori; 2004 May-Jun;90(3):299-302
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  • [Title] Neoadjuvant chemotherapy followed by radiotherapy in epidermoid carcinoma of anus.
  • AIM AND BACKGROUND: The purpose of this study was to analyze the efficacy of neoadjuvant fluorouracil-cisplatin chemotherapy combined with radiotherapy for anal cancer.
  • METHODS: Fourteen patients with epidermoid carcinoma of the anal canal were analyzed.
  • Treatment consisted of three cycles of 5-fluorouracil (1000 mg/m2 bolus on days 1-5) and cisplatin (60 mg/m2 bolus on day 1) followed by 50.4 Gy to the pelvis and perineum over 5.5 weeks.
  • CONCLUSIONS: Neoadjuvant chemotherapy with a cisplatin-based regimen rather than concurrent regimen plus radiotherapy may decrease complications without compromising survival or sphincter preservation.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Adult. Aged. Carcinoma, Transitional Cell / drug therapy. Carcinoma, Transitional Cell / radiotherapy. Chemotherapy, Adjuvant / adverse effects. Cisplatin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging. Radiotherapy Dosage. Radiotherapy, Adjuvant / adverse effects. Survival Analysis. Treatment Outcome

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  • (PMID = 15315309.001).
  • [ISSN] 0300-8916
  • [Journal-full-title] Tumori
  • [ISO-abbreviation] Tumori
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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45. McCarron PA, Donnelly RF, Zawislak A, Woolfson AD: Design and evaluation of a water-soluble bioadhesive patch formulation for cutaneous delivery of 5-aminolevulinic acid to superficial neoplastic lesions. Eur J Pharm Sci; 2006 Feb;27(2-3):268-79
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  • Photodynamic therapy of superficial neoplastic lesions generally uses high aminolevulinic acid (ALA) loadings (20%, w/w) in emulsion-type systems under occlusion.
  • This approach makes ALA dosing difficult and delivery to demanding areas, such as the vulval, perineal and perianal skin, are seldom possible.
  • This work evaluated a water-soluble bioadhesive patch, loaded with ALA, which can adhere to both intact skin and mucous surfaces.
  • ALA loading in the patch (38 mg cm(-2)) was chosen using a simple comparative procedure.
  • Tensile measurements showed that large ALA loadings did not adversely affect adhesion to porcine skin, achieving a mean strength of 1.7 N cm(-2).
  • Drug release studies demonstrated that 57% of ALA was released across an aqueous semi-permeable membrane within 6 h, compared to 42% released from a proprietary cream formulation.
  • The patch designed in this work is suited to definable ALA delivery to diverse regions, such as the lower female reproductive tract and lesions on exposed skin.
  • Adhesion is sufficiently tenacious to allow photodynamic therapy (PDT), without the need to immobilise patients for up to 6 h, as was common with the cream-under-occlusion approach.
  • [MeSH-major] Aminolevulinic Acid / administration & dosage. Drug Delivery Systems. Mucous Membrane / drug effects. Photosensitizing Agents / administration & dosage. Skin / drug effects. Tissue Adhesives
  • [MeSH-minor] Administration, Cutaneous. Animals. Carcinoma in Situ / drug therapy. Female. Fluorescence. Genital Neoplasms, Female / drug therapy. In Vitro Techniques. Mice. Mice, Hairless. Mice, Inbred BALB C. Skin Neoplasms / drug therapy. Swine

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  • (PMID = 16330192.001).
  • [ISSN] 0928-0987
  • [Journal-full-title] European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences
  • [ISO-abbreviation] Eur J Pharm Sci
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Photosensitizing Agents; 0 / Tissue Adhesives; 88755TAZ87 / Aminolevulinic Acid
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46. Winburn GB: Anal carcinoma or "just hemorrhoids"? Am Surg; 2001 Nov;67(11):1048-58
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  • [Title] Anal carcinoma or "just hemorrhoids"?
  • Cancers of the anal margin and anal canal are extremely rare and often misdiagnosed.
  • From January 1985 through July 2000, 50 patients were diagnosed with anal cancer at two institutions.
  • This retrospective review includes all available cases of anal cancer including all histologies.
  • Patient charts were analyzed for diagnosis, staging, treatment, survival, and recurrence rate.
  • The pathologic diagnosis included 44 (88%) with squamous cell carcinoma, three (6%) with melanoma, two (4%) with adenocarcinoma, and one (2%) with Paget's disease.
  • Chemoradiotherapy was the primary treatment modality in 25 patients (50%).
  • Three patients (6%) received an APR as primary treatment, three (6%) in combination with chemoradiation, and four (8%) for salvage therapy.
  • Fourteen patients (28%) underwent wide local excision (WLE) as the primary treatment.
  • Two patients (4%) underwent WLE plus chemoradiation therapy.
  • One patient (2%) underwent WLE and chemotherapy.
  • Thirteen patients (26%) died of anal cancer; the average time to death from diagnosis was 13.2 months.
  • Thirty-two patients (64%) are alive, and 30 (60%) of these patients are free of disease (mean time since diagnosis 32.5 months, range 2-151 months).
  • Six patients (12%) had recurrence after treatment (mean time to recurrence 12.6 months; range 3-26 months).
  • Anal cancers continue to present at an advanced stage, with a high mortality rate.
  • Anal melanoma in particular is an aggressive and highly fatal cancer.
  • APR remains the recommended salvage therapy for advanced anal carcinomas that fail primary treatment.
  • Early recognition and detection of primary and recurrent disease is necessary for improved outcome.
  • [MeSH-major] Anus Neoplasms / diagnosis. Carcinoma, Squamous Cell / diagnosis

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  • (PMID = 11730221.001).
  • [ISSN] 0003-1348
  • [Journal-full-title] The American surgeon
  • [ISO-abbreviation] Am Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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47. Blazy A, Hennequin C, Gornet JM, Furco A, Gérard L, Lémann M, Maylin C: Anal carcinomas in HIV-positive patients: high-dose chemoradiotherapy is feasible in the era of highly active antiretroviral therapy. Dis Colon Rectum; 2005 Jun;48(6):1176-81
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  • [Title] Anal carcinomas in HIV-positive patients: high-dose chemoradiotherapy is feasible in the era of highly active antiretroviral therapy.
  • BACKGROUND: Anal carcinoma, a common disease in HIV-positive patients, is usually treated with chemoradiotherapy.
  • Generally tolerance was poor before the availability of highly active antiretroviral therapies.
  • We report our experience of treating anal carcinoma in the era of new antiviral drugs.
  • PATIENTS AND METHODS: Between 1997 and 2001, nine men on highly active antiretroviral therapies with good immune status before chemoradiotherapy received concomitant chemoradiotherapy consisting of 5-fluorouracil and cisplatinum, and high-dose radiotherapy (60-70 Gy) for anal carcinoma.
  • CD4+ cell counts were <200/ml for four patients, between 200/ml and 500/ml for four, and >500/ml for one.
  • RESULTS: All patients received the planned dose of radiation (> or = 60 Gy).
  • The chemotherapy dose was reduced 25 percent in six patients.
  • Overall treatment time was 58 days.
  • Grade 3 hematologic or skin toxicity occurred in four patients.
  • No association was observed between high-grade toxicity and CD4+ cell count.
  • None of the patients developed opportunistic infections during follow-up.
  • Among them, four had no or minor anal function impairment at the last follow-up visit.
  • One patient with T4N2 disease relapsed locally one year after treatment and underwent salvage abdominoperineal excision.
  • CONCLUSION: High-dose chemoradiotherapy for anal carcinomas is feasible with low toxicity in HIV-positive patients treated with highly active antiretroviral therapies.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy. Cisplatin / administration & dosage. Fluorouracil / administration & dosage. HIV Infections / complications
  • [MeSH-minor] Adult. Anti-Retroviral Agents / administration & dosage. Antiretroviral Therapy, Highly Active. Combined Modality Therapy. Dose-Response Relationship, Drug. Feasibility Studies. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy, Adjuvant. Retrospective Studies. Treatment Outcome

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  • (PMID = 15906137.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anti-Retroviral Agents; 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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48. Edelman S, Johnstone PA: Combined modality therapy for HIV-infected patients with squamous cell carcinoma of the anus: outcomes and toxicities. Int J Radiat Oncol Biol Phys; 2006 Sep 1;66(1):206-11
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  • [Title] Combined modality therapy for HIV-infected patients with squamous cell carcinoma of the anus: outcomes and toxicities.
  • PURPOSE: We report toxicity and survival data of human immunodeficiency virus (HIV)-infected men with anal carcinoma treated with combined modality therapy (CMT) of radiotherapy and concurrent chemotherapy.
  • METHODS AND MATERIALS: A retrospective review was performed on the records of 17 HIV-positive patients with anal squamous cell carcinoma treated with CMT at our institution between 1991 and 2004.
  • Radiotherapy consisted of 30.6 to 45 Gy to the pelvis, total dose of 50.4 to 59.4 Gy to initial gross disease, at 1.8 Gy/fraction.
  • Chemotherapy consisted of 5-fluorouracil and either mitomycin C or cisplatin.
  • RESULTS: Significant acute skin and hematologic toxicity developed in 8 of 17 and 9 of 17 patients, respectively.
  • One patient died 12 days after treatment of progressive disease and sepsis.
  • Significant late toxic sequelae developed in 3 patients: 1 anorectal ulcer, 2 dermatologic (perianal ulceration, hemorrhagic perineal sores and suspected fissure).
  • For patients with Stage I-III disease, survival at last follow-up by low CD4 count (<200) vs. high count (>200) was 4 of 7 vs. 7 of 8, respectively; significant acute toxicities developed in 4 of 8 vs. 6 of 9, respectively.
  • CONCLUSION: For HIV patients with anal carcinoma, CMT yields reasonable local control with significant acute complications.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. HIV Infections / complications
  • [MeSH-minor] Adult. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy / adverse effects. Combined Modality Therapy / methods. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Mitomycin / adverse effects. Pancytopenia / chemically induced. Radiotherapy Dosage. Rectal Fistula / complications. Retrospective Studies


49. Newlin HE, Zlotecki RA, Morris CG, Hochwald SN, Riggs CE, Mendenhall WM: Squamous cell carcinoma of the anal margin. J Surg Oncol; 2004 May 1;86(2):55-62; discussion 63
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  • [Title] Squamous cell carcinoma of the anal margin.
  • PURPOSE: To define the optimal treatment of patients with squamous cell carcinoma (SCCA) of the anal margin.
  • METHODS: Nineteen patients treated with curative intent by radiotherapy (RT) alone or combined with adjuvant chemotherapy (CTX) between 1979 and June 2000 were analyzed.
  • One T1 patient developed inguinal lymph node metastases and subsequently died secondary to regional and distant disease.
  • The remaining 14 patients were alive and disease-free from 52 to 143 months after treatment.
  • No patient suffered a severe complication or required a diverting colostomy or an abdominoperineal resection (APR) after treatment.
  • Therefore, the choice of treatment depends on the anticipated functional result.
  • CONCLUSIONS: Patients with SCCA of the anal margin have a high likelihood of cure with sphincter preservation after RT or RT and CTX.
  • [MeSH-major] Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Dose Fractionation. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Humans. Lymph Nodes / pathology. Lymphatic Irradiation. Lymphatic Metastasis. Male. Middle Aged. Mitomycin / administration & dosage. Radiotherapy Dosage. Survival Analysis. Treatment Outcome


50. Berman B, Poochareon VN, Villa AM: Novel dermatologic uses of the immune response modifier imiquimod 5% cream. Skin Therapy Lett; 2002 Nov;7(9):1-6
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  • Imiquimod is the first of a new class of drugs to emerge in the treatment of various dermatologic disorders.
  • As an immune response modifier, it has been shown to have potent antiviral and antitumor properties through the stimulation of innate and cell mediated immune pathways.
  • It is currently approved for the treatment of external genital and perianal warts, but has also been found to be an effective treatment for a host of other virus-associated dermatologic lesions, including common and flat warts, molluscum contagiosum and herpes simples 2.
  • Oncological lesions showing improvement with the use of imiquimod include basal cell carcinoma, actinic keratosis, squamous cell carcinoma in situ, malignant melanoma, cutaneous T-cell lymphoma, and cutaneous extramammary Paget's disease.
  • This extensive array of disorders treated successfully with imiquimod warrants further study of this novel and valuable drug.
  • [MeSH-major] Adjuvants, Immunologic / therapeutic use. Aminoquinolines / therapeutic use. Skin Diseases / drug therapy

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  • (PMID = 12548325.001).
  • [ISSN] 1201-5989
  • [Journal-full-title] Skin therapy letter
  • [ISO-abbreviation] Skin Therapy Lett.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Canada
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / Aminoquinolines; 99011-02-6 / imiquimod
  • [Number-of-references] 53
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51. Gubinelli E, Posteraro P, Cocuroccia B, Girolomoni G: Epidermodysplasia verruciformis with multiple mucosal carcinomas treated with pegylated interferon alfa and acitretin. J Dermatolog Treat; 2003 Sep;14(3):184-8
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  • Epidermodysplasia verruciformis (EV) is characterized by abnormal genetically-determined susceptibility to widespread and persistent infection of the skin with human papillomaviruses (HPV).
  • Skin malignant changes are very common and occur on sun-exposed areas.
  • Several treatments have been used but without consistent benefit.
  • Recently, retinoids and alpha-interferon, alone or in combination, have been reported to be of value in the therapy of EV lesions.
  • We present the case of a 43-year-old white female affected by EV who developed multiple squamous cell carcinomas in the oral and genital mucosae during the previous four years.
  • Both wart and cancer lesions harbored HPV24 along with the novel putative HPV type FA51.
  • The patient was treated with a combination of acitretin (0.2 mg/kg per day) and peginterferon alfa-2b (1 microg/kg per week s.c.) for one year, with marked improvement of verrucous lesions and no recurrence of mucosal cancer.
  • Thereafter, interferon was stopped whereas acitretin therapy was continued, but a new Bowen's disease developed in the perianal region, and the acitretin dose was increased at 0.5 mg/kg per day.
  • At six-month follow-up, only a low number of flat warts persisted, and no clinical signs of cutaneous or mucosal carcinoma were evident.
  • [MeSH-major] Acitretin / therapeutic use. Antiviral Agents / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Epidermodysplasia Verruciformis / drug therapy. Interferon-alpha / therapeutic use. Keratolytic Agents / therapeutic use. Papillomaviridae / isolation & purification. Skin Neoplasms / drug therapy
  • [MeSH-minor] Adult. Drug Therapy, Combination. Female. Humans. Recombinant Proteins

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  • (PMID = 14522631.001).
  • [ISSN] 0954-6634
  • [Journal-full-title] The Journal of dermatological treatment
  • [ISO-abbreviation] J Dermatolog Treat
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antiviral Agents; 0 / Interferon-alpha; 0 / Keratolytic Agents; 0 / Recombinant Proteins; 99210-65-8 / interferon alfa-2b; LCH760E9T7 / Acitretin
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52. Provencher S, Oehler C, Lavertu S, Jolicoeur M, Fortin B, Donath D: Quality of life and tumor control after short split-course chemoradiation for anal canal carcinoma. Radiat Oncol; 2010;5:41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Quality of life and tumor control after short split-course chemoradiation for anal canal carcinoma.
  • PURPOSE: To evaluate quality of life (QOL) and outcome of patients with anal carcinoma treated with short split-course chemoradiation (CRT).
  • METHODS: From 1991 to 2005, 58 patients with anal cancer were curatively treated with CRT.
  • External beam radiotherapy (52 Gy/26 fractions) with elective groin irradiation (24 Gy) was applied in 2 series divided by a median gap of 12 days.
  • Chemotherapy including fluorouracil and Mitomycin-C was delivered in two sequences.
  • Significant anal pain or fecal incontinence was infrequently reported.
  • Skin toxicity grade 3 or 4 was present in 76% of patients and erectile dysfunction was reported in 100% of male patients.
  • CONCLUSIONS: Short split-course CRT for anal carcinoma seems to be associated with good local control, survival and long-term global QOL.
  • However, it is also associated with severe acute skin toxicity and sexual dysfunction.
  • Implementation of modern techniques such as intensity-modulated radiation therapy (IMRT) might be considered to reduce toxicity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Quality of Life. Radiotherapy Dosage
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Retrospective Studies. Survival Rate. Time Factors. Treatment Outcome

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  • (PMID = 20492729.001).
  • [ISSN] 1748-717X
  • [Journal-full-title] Radiation oncology (London, England)
  • [ISO-abbreviation] Radiat Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ PMC2883545
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53. Das P, Bhatia S, Eng C, Ajani JA, Skibber JM, Rodriguez-Bigas MA, Chang GJ, Bhosale P, Delclos ME, Krishnan S, Janjan NA, Crane CH: Predictors and patterns of recurrence after definitive chemoradiation for anal cancer. Int J Radiat Oncol Biol Phys; 2007 Jul 1;68(3):794-800
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Predictors and patterns of recurrence after definitive chemoradiation for anal cancer.
  • PURPOSE: To evaluate patterns of locoregional failure, and predictors of recurrence and survival in patients treated with chemoradiation for anal cancer.
  • METHODS AND MATERIALS: Between September 1992 and August 2004, 167 patients with nonmetastatic squamous cell anal carcinoma were treated with definitive chemoradiation.
  • Concurrent chemotherapy was given with 5-fluorouracil and cisplatin in 117 patients, 5-fluorouracil and mitomycin C in 24 patients, and other regimens in 26 patients.
  • CONCLUSIONS: Trials of more aggressive and innovative locoregional and systemic therapies are warranted in high-risk patients, based on their T and N stages.
  • [MeSH-major] Anus Neoplasms / mortality. Anus Neoplasms / therapy. Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / therapy. Chemotherapy, Adjuvant / mortality. Neoplasm Recurrence, Local / mortality. Neoplasm Recurrence, Local / prevention & control. Radiotherapy, Adjuvant / mortality
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Prognosis. Risk Assessment / methods. Risk Factors. Survival Analysis. Survival Rate. Texas / epidemiology. Treatment Outcome

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  • (PMID = 17379452.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
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54. Eng C: Anal cancer: current and future methodology. Cancer Invest; 2006 Aug-Sep;24(5):535-44
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  • [Title] Anal cancer: current and future methodology.
  • Despite the small number of patients affected by carcinoma of the anal canal it remains one of the most challenging cancers to treat.
  • For although it is one of the few malignancies that may be cured with chemoradiation alone, the use of combined modality therapy may result in significant treatment-related morbidity.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Anus Neoplasms
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adenocarcinoma / radiotherapy. Carcinoma in Situ / drug therapy. Carcinoma in Situ / pathology. Carcinoma in Situ / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / radiotherapy. Cisplatin / therapeutic use. Clinical Trials as Topic. Fluorouracil / therapeutic use. HIV Infections / complications. Humans. Mitomycin / therapeutic use. Neoadjuvant Therapy. Neoplasm Metastasis. Neoplasm Recurrence, Local. Neoplasm, Residual. Papillomavirus Infections / complications

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  • (PMID = 16939964.001).
  • [ISSN] 0735-7907
  • [Journal-full-title] Cancer investigation
  • [ISO-abbreviation] Cancer Invest.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Number-of-references] 64
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55. Bilimoria KY, Bentrem DJ, Ko CY, Stewart AK, Winchester DP, Talamonti MS, Halverson AL: Squamous cell carcinoma of the anal canal: utilization and outcomes of recommended treatment in the United States. Ann Surg Oncol; 2008 Jul;15(7):1948-58
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  • [Title] Squamous cell carcinoma of the anal canal: utilization and outcomes of recommended treatment in the United States.
  • BACKGROUND: Over the past two decades, recommended treatment for squamous cell carcinoma of the anal canal has shifted from surgery to primary chemoradiation.
  • Our objectives were (1) to evaluate treatment trends over the past 20 years, (2) to assess contemporary treatment utilization, and (3) to examine the impact of recommended vs nonguideline treatment on survival.
  • METHODS: From the National Cancer Data Base (1985-2005), 38,882 patients with anal canal cancer were identified.
  • Regression models were used to assess factors associated with use of nonguideline treatment (vs chemoradiation +/-surgery).
  • Univariate and multivariate methods were used to assess the impact of treatment on survival.
  • RESULTS: From 1985 to 2005, the use of chemoradiation increased significantly with a concomitant decrease in treatment with surgery alone (P < .0001).
  • However, only 74.9% (5014 of 6696) of patients underwent primary chemoradiation therapy in 2003-2005.
  • Overall, 22.7% (1523 of 6696) of patients received treatment that was not concordant with established guidelines: primary surgery (13.0%) and primary chemotherapy or radiation (9.7%).
  • Patients were significantly less likely to receive guideline treatment if male, older, black or Hispanic, more severe comorbidities, or Stage I (vs Stage II or III).
  • Patients undergoing chemoradiation ( +/- surgery) had higher 5-year survival rates than patients who received nonguideline treatment (64% vs 58%; hazard ratio 0.82, 95% confidence interval [95% CI] 0.77-0.87; P < .0001).
  • CONCLUSION: Primary chemoradiation therapy has supplanted surgical treatment and is associated with better outcomes; however, nearly a quarter of patients are still receiving treatment that is not concordant with established guidelines.
  • [MeSH-major] Anus Neoplasms / therapy. Neoplasms, Squamous Cell / therapy
  • [MeSH-minor] Aged. Aged, 80 and over. Combined Modality Therapy. Female. Guideline Adherence. Humans. Male. Neoplasm Staging. Survival Rate. Treatment Outcome. United States

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  • (PMID = 18414951.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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56. Takahashi A, Yamamoto A: [Diagnosis and treatment of extramammary Paget's disease]. Gan To Kagaku Ryoho; 2004 Mar;31(3):356-9
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  • [Title] [Diagnosis and treatment of extramammary Paget's disease].
  • It occurs most frequently in the external genitalia, followed by perianal and axillary regions.
  • However, if the tumor cells infiltrate into the dermis and form a clinically manifest nodule, it becomes an invasive carcinoma that can be classified as adnexal adenocarcinoma of the skin.
  • Surgery with wide local excision is the first choice of treatment, and the prognosis is comparatively favorable in the early stages.
  • However, when tumor cells infiltrate into the dermis and advance to Paget's carcinoma, it is referred to as adenocarcinoma of the skin and has a poor prognosis.
  • We report an effective treatment of extramammary Paget's disease in advanced stages' including our case.
  • No standard treatment with a significant effect has yet been established.
  • There are few reports of cases responsive to chemotherapy, and treatment in advanced stages is extremely difficult at present.
  • [MeSH-major] Paget Disease, Extramammary. Skin Neoplasms
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols. Diagnosis, Differential. Genitalia, Male. Humans. Male. Perineum. Prognosis. Radiotherapy, Adjuvant

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  • (PMID = 15045940.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 17
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57. Mistrangelo M, Mobiglia A, Bellò M, Beltramo G, Cassoni P, Mussa A: [The technique of sentinel lymph nodes in patients with anus neoplasm]. Suppl Tumori; 2005 May-Jun;4(3):S32-3
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  • [Transliterated title] La tecnica del linfonodo sentinella nei pazienti affetti da neoplasia dell'ano.
  • Anal cancer is a rare neoplasm, representing 1-2% of all large bowel cancers.
  • Surgical excision by abdominoperineal resection has been the standard treatment.
  • In the 1950s it was evident that the morbidity associated with lymphnode dissection was much greater than any survival benefit and this procedure was abandoned.
  • Since 1974 "multimodality treatment" with a combination of radiation and chemotherapy has become the standard treatment.
  • In order to assess inguinal lymph node status we applied the sentinel node technique to patients affected by anal cancer.
  • A surgical biopsy of sentinel node was performed in all patients with a detection rate of 100%.
  • Twelve patients (80%) were treated in local anesthesia and they were dismissed the same day of surgical procedure.
  • Considering the strong correlation between prognosis and node involvement, we consider this technique an important and simple method for evaluating the lymph node status and for an adequate pre-treatment staging of anal carcinoma. fundamental in the choice of radiation plane.
  • In particular inguinal radiotherapy could be reserved for N1 patients only. avoiding the morbidity related to this procedure in N0 patients.

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  • (PMID = 16437886.001).
  • [ISSN] 2283-5423
  • [Journal-full-title] I supplementi di Tumori : official journal of Società italiana di cancerologia ... [et al.]
  • [ISO-abbreviation] Suppl Tumori
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Italy
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58. Coquard R, Cenni JC, Artru P, Chalabreysse P, Queneau PE, Taieb S, Alessio A, Lledo G: [Definitive treatment of anal canal carcinoma with radiotherapy: adverse impact of a pre-radiation resection. A retrospective study of 57 patients treated with curative intent]. Cancer Radiother; 2009 Dec;13(8):715-20
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  • [Title] [Definitive treatment of anal canal carcinoma with radiotherapy: adverse impact of a pre-radiation resection. A retrospective study of 57 patients treated with curative intent].
  • [Transliterated title] Radiothérapie à visée curative du carcinome du canal anal : impact défavorable d'une résection préalable. Etude rétrospective de 57 patients traités en intention curative.
  • PURPOSE: To describe retrospectively the overall survival, the cancer specific survival and the tumor control in an homogeneous series of patients with epidermoid carcinoma of the anal canal treated with definitive radiotherapy; to assess the impact of brachytherapy, chemotherapy and pre-radiotherapy resection on the risk of recurrence.
  • PATIENTS AND METHODS: From 1997 to 2007, 57 patients (pts) presenting with an epidermoid carcinoma of the anal canal (T1: 14, T2: 33, T3-4: 10, N0: 31, N1: 19, N2: 3, N3: 4, M0: 57) were treated with definitive radiotherapy by the same radiation oncologist.
  • The treatment included an external beam irradiation (EBRT) given to the posterior pelvis (45Gy/25 fractions) and, six weeks later, a boost delivered with interstitial brachytherapy (37/57) or external beam irradiation (20/57).
  • A concurrent platinum based chemotherapy was done in 42 pts.
  • In univariate analysis, the risk of relapse was higher in patients who had undergone a pre-radiation excision (p=0.018), in those who did not receive chemotherapy (p=0.076) and in those who were irradiated on a belly board (p=0.049).
  • In multivariate analysis, a pre-radiotherapy resection (p=0.084) had an inverse impact on the tumour control reaching the level of statistical significance and the use of a belly board was of marginal influence (p=0.13).
  • CONCLUSION: Radiotherapy and chemoradiation with cisplatine-based chemotherapy cure a vast majority of patients with epidermoid carcinoma of the anal canal.
  • Therapeutic factors that may interfere with the definition of the target volume and the patients' repositioning may decrease the efficacy of radiotherapy.
  • [MeSH-major] Anal Canal / surgery. Anus Neoplasms / mortality. Anus Neoplasms / therapy. Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Agents / therapeutic use. Brachytherapy. Chemotherapy, Adjuvant. Cisplatin / therapeutic use. Dose Fractionation. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / epidemiology. Patient Positioning. Retrospective Studies

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  • (PMID = 19854092.001).
  • [ISSN] 1769-6658
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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59. Charnley N, Choudhury A, Chesser P, Cooper RA, Sebag-Montefiore D: Effective treatment of anal cancer in the elderly with low-dose chemoradiotherapy. Br J Cancer; 2005 Apr 11;92(7):1221-5
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  • [Title] Effective treatment of anal cancer in the elderly with low-dose chemoradiotherapy.
  • Chemoradiotherapy (CRT) is accepted as the standard initial treatment for squamous cell anal cancer.
  • In all, 16 patients with biopsy-proven squamous cell carcinoma of the anal canal or margin and performance status or co-morbidity precluding the use of full-dose CRT were included in this protocol.
  • Patients received a dose of 30 Gy to the gross tumour volume plus 3 cm margin in all directions.
  • Concurrent chemotherapy comprised 5-fluorouracil 600 mg m(-2) given over 24 h on days 1-4 of radiotherapy.
  • The treatment was well tolerated.
  • All 16 patients completed treatment as planned.
  • Only one patient experienced any grade 3 toxicity (skin).
  • This is a well-tolerated regimen for elderly/poor performance patients with anal cancer, which can achieve high rates of local control and survival.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Fluorouracil / therapeutic use. Frail Elderly
  • [MeSH-minor] Age Factors. Aged. Aged, 80 and over. Combined Modality Therapy. Comorbidity. Female. Health Status. Humans. Male. Survival Analysis. Treatment Outcome

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  • (PMID = 15798772.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] England
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  • [Other-IDs] NLM/ PMC2361984
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60. Myerson RJ, Kong F, Birnbaum EH, Fleshman JW, Kodner IJ, Picus J, Ratkin GA, Read TE, Walz BJ: Radiation therapy for epidermoid carcinoma of the anal canal, clinical and treatment factors associated with outcome. Radiother Oncol; 2001 Oct;61(1):15-22
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  • [Title] Radiation therapy for epidermoid carcinoma of the anal canal, clinical and treatment factors associated with outcome.
  • BACKGROUND AND PURPOSE: In recent years, treatment with combined chemotherapy and radiation has become the standard of care for epidermoid carcinoma of the anus.
  • MATERIALS AND METHODS: During the period 1975-1997, 106 patients with epidermoid carcinoma of the anal canal underwent radiation therapy.
  • Treatment policies evolved from radiation therapy alone or with surgery, to combined chemotherapy and radiation followed by surgery, to combined chemotherapy and radiation.
  • The most common additional malignancies were gynecologic (nine cases), head and neck (six cases), and lung cancer (five cases).
  • CONCLUSIONS: For T1/T2N0 disease, moderate doses of radiation combined with chemotherapy provided adequate treatment.
  • Because of the occurrence of additional malignancy, patients with anal cancer should receive general oncologic screening in long-term follow-up.
  • [MeSH-major] Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Middle Aged. Precipitating Factors. Radiotherapy Dosage. Treatment Outcome

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  • (PMID = 11578724.001).
  • [ISSN] 0167-8140
  • [Journal-full-title] Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
  • [ISO-abbreviation] Radiother Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
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61. Ghouti L, Houvenaeghel G, Moutardier V, Giovannini M, Magnin V, Lelong B, Bardou VJ, Delpero JR: Salvage abdominoperineal resection after failure of conservative treatment in anal epidermoid cancer. Dis Colon Rectum; 2005 Jan;48(1):16-22
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  • [Title] Salvage abdominoperineal resection after failure of conservative treatment in anal epidermoid cancer.
  • PURPOSE: Radiotherapy alone or with combined chemotherapy is the first therapeutic option for epidermoid carcinoma of the anal canal.
  • Failure of this conservative treatment may benefit of salvage abdominoperineal resection.
  • METHODS: Medical charts of 36 patients (median age, 57.9 years) who underwent salvage abdominoperineal resection after failure of conservative treatment between 1987 and 2002 were reviewed retrospectively.
  • CONCLUSIONS: Despite high incidence of perineal morbidity, salvage abdominoperineal resection for epidermoid carcinomas of the anal canal has a high long-term survival rate.
  • [MeSH-major] Abdomen / surgery. Anus Neoplasms / surgery. Carcinoma, Squamous Cell / surgery. Perineum / surgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Disease-Free Survival. Female. Humans. Male. Middle Aged. Morbidity. Retrospective Studies. Salvage Therapy

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  • (PMID = 15690652.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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62. Badin S, Iqbal A, Sikder M, Chang VT: Persistent pain in anal cancer survivors. J Cancer Surviv; 2008 Jun;2(2):79-83
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  • [Title] Persistent pain in anal cancer survivors.
  • Combined modality treatment with chemotherapy and radiation has dramatically improved both disease-free and overall survival.
  • Little is known about symptomatic complications of treatment.
  • RESULTS: Two patients presented with painful anal lesions that were diagnosed as squamous cell carcinoma of the anus.
  • Despite successful treatment with chemotherapy and radiation, their pain syndromes worsened after treatment with development of a lumbosacral plexopathy that required regular followup, imaging, and pain medications.
  • CONCLUSION: Pain syndromes may worsen after successful treatment given with curative intent, and may be a form of treatment toxicity.
  • IMPLICATIONS FOR CANCER SURVIVORS: Treatment related lumbosacral plexopathy may be an unrecognized consequence of the successful treatment of anal carcinoma.

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  • (PMID = 18648976.001).
  • [ISSN] 1932-2267
  • [Journal-full-title] Journal of cancer survivorship : research and practice
  • [ISO-abbreviation] J Cancer Surviv
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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63. Efron JE, Pikarsky AJ, Gervaz P, Locker G, Weiss EG, Wexner SD, Nogueras JJ: The efficacy of chemoradiation therapy in HIV seropositive patients with squamous cell carcinoma of the anus. Colorectal Dis; 2001 Nov;3(6):402-5
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  • [Title] The efficacy of chemoradiation therapy in HIV seropositive patients with squamous cell carcinoma of the anus.
  • OBJECTIVE: The aim was to assess the efficacy of chemoradiation therapy for squamous cell carcinoma of the anal canal in HIV seropositive patients.
  • PATIENTS AND METHODS: A retrospective review of all patients with squamous cell carcinoma of the anus treated primarily with combined chemotherapy (5-fluorouracil and mitomycin) and radiotherapy or local excision was undertaken comparing HIV seropositive to HIV seronegative patients.
  • The HIV positive group included a higher proportion of males and a significantly greater history of prior treatment for condyloma.
  • The CD4 count of HIV positive patients did not correlate either with their ability to complete the prescribed treatment regimen or with subsequent recurrence.
  • Tolerance of this therapy in HIV seropositive patients or recurrence after therapy are not related to the patient's CD4 cell count.

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  • (PMID = 12790938.001).
  • [ISSN] 1462-8910
  • [Journal-full-title] Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
  • [ISO-abbreviation] Colorectal Dis
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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64. Nadal SR, Horta SH, Calore EE, Manzione CR: [Outcome of treatment of anal squamous cell carcinoma and its precursor in HIV-infected patients]. Rev Assoc Med Bras (1992); 2007 Jul-Aug;53(4):365-9
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  • [Title] [Outcome of treatment of anal squamous cell carcinoma and its precursor in HIV-infected patients].
  • [Transliterated title] Resultados do tratamento do carcinoma espinocelular anal e do seu precursor em doentes HIV-positivos.
  • OBJECTIVE: Incidence of anal squamous cell carcinoma is increasing mainly among HIV-positive patients.
  • Treatment consists of radiotherapy and chemotherapy, sometimes followed by tumor resection.
  • The objective was to evaluate the follow-up of such patients to verify recurrences and evolution from HAIN to cancer.
  • This is a report of cases treated at the "Instituto de Infectologia Emílio Ribas", Sao Paulo, Brazil.
  • Thirty patients had high grade anal intra-epithelial neoplasia (HAIN), treated with local resection, and 15 with anal canal invasive squamous cell carcinoma were first submitted to chemo radiation, while biopsies were obtained during follow-up.
  • RESULTS: Patients with HAIN had recurrences in 16.7% of cases and remained cancer free for up to five years.
  • Chemoradiation was not possible in five patients with invasive carcinoma (40%) because three had advanced AIDS and two refused treatment.
  • Eight (88.8%) out of nine patients had complete response to chemoradiation and remained cancer free for a period from three to six years.
  • CONCLUSION: We concluded that HAIN can recur after local resection in HIV-positive patients but does not evolve to invasive carcinoma.
  • Invasive cancer can be treated in the same way as in HIV seronegative persons, when clinical conditions permit.
  • [MeSH-major] Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy. HIV Seropositivity. Neoplasm Recurrence, Local
  • [MeSH-minor] Adult. Biopsy. Female. Follow-Up Studies. Humans. Incidence. Male. Middle Aged. Neoplasm Staging. Treatment Failure. Treatment Outcome. Treatment Refusal / statistics & numerical data


65. Takashima A, Shimada Y, Hamaguchi T, Ito Y, Masaki T, Yamaguchi S, Kondo Y, Saito N, Kato T, Ohue M, Higashino M, Moriya Y, Colorectal Cancer Study Group of the Japan Clinical Oncology Group: Current therapeutic strategies for anal squamous cell carcinoma in Japan. Int J Clin Oncol; 2009 Oct;14(5):416-20
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  • [Title] Current therapeutic strategies for anal squamous cell carcinoma in Japan.
  • BACKGROUND: In Western countries, chemoradiotherapy (CRT) is well established as the standard therapy for stages II/III anal squamous cell carcinoma (ASCC).
  • In Japan, the therapeutic modalities for and outcomes of this disease have not been clarified because ASCC is quite rare.
  • The Colorectal Cancer Study Group of the Japan Clinical Oncology Group (JCOG-CCSG) conducted a survey to determine the current therapeutic strategies for ASCC in Japan.
  • METHODS: In July 2006, a questionnaire was sent to 49 institutions affiliated with the JCOG-CCSG to gather information on numbers of cases, therapeutic modalities, and outcomes.
  • CRT was performed in 25 patients (45%); surgery in 17 (31%); surgery combined with radiotherapy (RT), chemotherapy, or CRT in 8 (15%); and RT in 5 (9%).
  • [MeSH-major] Anus Neoplasms / therapy. Asian Continental Ancestry Group. Carcinoma, Squamous Cell / therapy. Digestive System Surgical Procedures
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Disease-Free Survival. Female. Health Care Surveys. Humans. Japan / epidemiology. Kaplan-Meier Estimate. Male. Middle Aged. Neoplasm Staging. Radiotherapy, Adjuvant. Retrospective Studies. Surveys and Questionnaires. Time Factors. Treatment Outcome

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  • (PMID = 19856049.001).
  • [ISSN] 1437-7772
  • [Journal-full-title] International journal of clinical oncology
  • [ISO-abbreviation] Int. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] Japan
  • [Investigator] Kondo Y; Ohtsuka K; Shiiba K; Sato T; Yoshimi F; Kotake K; Sawada T; Mochizuki H; Konishi F; Saito N; Moriya Y; Masaki T; Aoki T; Takahashi K; Hasegawa H; Kenichi S; Sumiyama Y; Sato T; Akaike M; Kudo S; Yamada T; Munakata Y; Shigeski Y; Kato T; Maeda K; Koizumi K; Monden M; Ohue M; Higashino M; Tanigawa M; Fukunaga M; Kato T; Okamura S; Kimura H; Okajima M; Takakura N; Tanada M; Shirouzu K; Kitano S
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66. Potthoff A, Brockmeyer NH: [HIV-associated tumors]. Hautarzt; 2006 Nov;57(11):988, 990-3
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  • While Kaposi sarcoma is seen less frequently since the introduction of antiretroviral therapy, lymphoma and other malignancies are an increasing therapeutic challenge.
  • The incidence of HPV-related anal carcinoma and its precursor lesions is rising so dramatically that screening programs as they are already established for cervical carcinoma should be implemented.
  • [MeSH-minor] AIDS-Related Opportunistic Infections / complications. Adult. Antiretroviral Therapy, Highly Active. Anus Neoplasms / etiology. Carcinoma, Hepatocellular / etiology. Female. HIV Seropositivity / complications. Humans. Liver Neoplasms / etiology. Lung Neoplasms / drug therapy. Lung Neoplasms / etiology. Lymphoma, AIDS-Related / diagnosis. Lymphoma, AIDS-Related / drug therapy. Lymphoma, AIDS-Related / etiology. Male. Middle Aged. Papillomavirus Infections / complications. Risk Factors. Skin Neoplasms / etiology. Smoking / adverse effects. Uterine Cervical Neoplasms / etiology


67. Gates AE, Kaplan LD: AIDS malignancies in the era of highly active antiretroviral therapy. Oncology (Williston Park); 2002 Apr;16(4):441-51, 456, 459
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  • [Title] AIDS malignancies in the era of highly active antiretroviral therapy.
  • The introduction of highly active antiretroviral therapy (HAART) has had a dramatic impact on the morbidity and mortality of individuals living with human immunodeficiency virus (HIV).
  • On the contrary, the incidence of invasive cervical carcinoma has not significantly changed in the HAART era.
  • The impact of HAART on the epidemiology of other HIV-associated malignancies, including Hodgkin's disease and anal carcinoma, remains unclear.
  • Data regarding the impact of HAART on the natural history and treatment outcomes of HIV-associated malignancies are limited.
  • The possibility of direct and indirect roles of HIV in HIV-related carcinogenesis suggests that antiretroviral therapy may be an important component of the treatment strategy for several HIV-related malignancies.
  • Patients with HIV-NHL treated with HAART in addition to chemotherapy experience fewer intercurrent opportunistic infections.
  • Furthermore, the simultaneous administration of HAART and chemotherapy does not appear to significantly increase toxicity.
  • Whether the combination of HAART and standard therapy results in improved survival remains uncertain.
  • [MeSH-major] Acquired Immunodeficiency Syndrome / complications. Antiretroviral Therapy, Highly Active / adverse effects. Central Nervous System Neoplasms / etiology. Lymphoma, Non-Hodgkin / etiology. Sarcoma, Kaposi / etiology


68. Vatra B, Sobhani I, Aparicio T, Girard PM, Puy Montbrun TD, Housset M, Baillet F, Hecht F, Chossidow D, Soulé JC: [Anal canal squamous-cell carcinomas in HIV positive patients: clinical features, treatments and prognosis]. Gastroenterol Clin Biol; 2002 Feb;26(2):150-6
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  • [Title] [Anal canal squamous-cell carcinomas in HIV positive patients: clinical features, treatments and prognosis].
  • [Transliterated title] Caractéristiques cliniques, thérapeutiques et pronostiques des carcinomes épidermoïdes du canal anal chez les malades VIH positifs.
  • The prevalence of squamous-cell carcinoma of the anus seems to be increasing in HIV positive patients.
  • AIMS: To assess the prognosis of anal squamous-cell carcinoma in HIV positive patients as well as clinical features and treatment procedures.
  • METHODS: A series of 20 HIV positive patients presenting with invasive anal squamous-cell carcinoma was retrospectively analyzed.
  • Data have been compared to those obtained from 24 randomly selected HIV negative patients who were followed during the same periods in the same centers for anal carcinoma with similar histopathological features.
  • No difference was observed between the two groups concerning the clinical features leading to anal cancer diagnosis, although HIV positive patients were younger.
  • Anal cancer was more frequently associated with lymph node metastasis in HIV positive (60%) than in HIV negative (17%) patients, although its size was similar in both groups.
  • Radiotherapy was similarly performed in both groups, while chemotherapy was administered less frequently in HIV positive than in HIV negative patients (54% vs 25%).
  • Immediate side effects and mortality at 1 year follow-up were similar in both groups, whereas the objective initial response to therapy (50% versus 88%), the remission rate with anal conservation at 1 year follow-up (45% versus 88%), and the mortality at 3 years were better in HIV negative patients.
  • CONCLUSION: The prognosis of anal squamous-cell carcinoma is poor in HIV positive patients.
  • This correlates with a more advanced tumor stage and an alteration of systemic immunity status at the time of diagnosis and less response rate to treatment.
  • Detection of precancerous lesions and treatment procedures should be evaluated in HIV infected patients.
  • [MeSH-major] Anus Neoplasms / diagnosis. Anus Neoplasms / therapy. Carcinoma, Squamous Cell / diagnosis. Carcinoma, Squamous Cell / therapy. HIV Seropositivity / complications
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents / therapeutic use. Female. Homosexuality. Humans. Lymphatic Metastasis. Male. Middle Aged. Prognosis. Radiotherapy. Surgical Procedures, Operative. Treatment Outcome

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  • [CommentIn] Gastroenterol Clin Biol. 2002 Feb;26(2):147-9 [11938065.001]
  • (PMID = 11938066.001).
  • [ISSN] 0399-8320
  • [Journal-full-title] Gastroentérologie clinique et biologique
  • [ISO-abbreviation] Gastroenterol. Clin. Biol.
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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69. Myerson RJ, Outlaw ED, Chang A, Birnbaum EH, Fleshman JW, Grigsby PW, Kodner IJ, Malayapa RS, Mutch MG, Parikh P, Picus J, Tan BR: Radiotherapy for epidermoid carcinoma of the anus: thirty years' experience. Int J Radiat Oncol Biol Phys; 2009 Oct 1;75(2):428-35
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  • [Title] Radiotherapy for epidermoid carcinoma of the anus: thirty years' experience.
  • PURPOSE: To evaluate the factors associated with disease control and morbidity after radiotherapy for anal carcinoma.
  • METHODS AND MATERIALS: Between 1975 and 2005, 194 patients with localized epidermoid anal carcinoma underwent radiotherapy.
  • Treatment evolved from radiotherapy with or without surgery, to preoperative chemoradiotherapy, to definitive chemoradiotherapy (CRT).
  • No association was found with gender, age, preoperative vs. definitive CRT, or human immunodeficiency virus status.
  • The radiotherapy factors associated with Grade 3 or greater late morbidity included anorectal morbidity with tumor dose (29% with a dose > or =55 Gy vs. 9% otherwise), small bowel injury with technique (9% with anteroposterior-posteroanterior supine vs. 0.7% with multiple fields prone), and bone injury with femoral head dose (9% with a dose of > or =44 Gy vs. 0.7% otherwise).
  • Of the 194 patients, 56 had 68 additional malignancies, mainly either antedating the anal cancer or outside the radiation fields.
  • We also discuss the treatment planning implications of the late morbidity findings.
  • [MeSH-major] Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Analysis of Variance. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy / methods. Combined Modality Therapy / trends. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. HIV Seropositivity / complications. Hospitals, University. Humans. Male. Middle Aged. Missouri. Mitomycin / administration & dosage. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / radiotherapy. Neoplasm Staging. Neoplasms, Multiple Primary / pathology. Neoplasms, Radiation-Induced / pathology. Radiation Injuries / pathology. Radiotherapy Dosage. Salvage Therapy / methods


70. Gurfinkel R, Walfisch S: Combined treatment of basaloid anal carcinoma using cisplatin, 5-fluorouracil and resection of hepatic metastasis. Tech Coloproctol; 2005 Dec;9(3):235-6
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  • [Title] Combined treatment of basaloid anal carcinoma using cisplatin, 5-fluorouracil and resection of hepatic metastasis.
  • The combination of chemotherapy and radiotherapy with subsequent repeated local biopsy has become the standard treatment of epidermoid carcinoma.
  • The optimal treatment of metastatic anal carcinomas is controversial.
  • We present the case of 54-year-old woman with a diagnosis of metastatic basaloid anal carcinoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / pathology. Carcinoma, Squamous Cell / secondary. Hepatectomy / methods. Liver Neoplasms / secondary. Liver Neoplasms / therapy
  • [MeSH-minor] Biopsy, Needle. Chemotherapy, Adjuvant. Cisplatin / therapeutic use. Combined Modality Therapy. Female. Fluorouracil / therapeutic use. Follow-Up Studies. Humans. Immunohistochemistry. Middle Aged. Neoplasm Staging. Risk Assessment. Treatment Outcome

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  • (PMID = 16328122.001).
  • [ISSN] 1123-6337
  • [Journal-full-title] Techniques in coloproctology
  • [ISO-abbreviation] Tech Coloproctol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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71. Mitchell SE, Mendenhall WM, Zlotecki RA, Carroll RR: Squamous cell carcinoma of the anal canal. Int J Radiat Oncol Biol Phys; 2001 Mar 15;49(4):1007-13
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  • [Title] Squamous cell carcinoma of the anal canal.
  • PURPOSE: To report the results of primary radiotherapy for treatment of anal canal carcinoma from the University of Florida series and review issues related to treatment of this disease.
  • METHODS AND MATERIALS: Forty-nine patients were treated with primary radiation therapy (RT) for cure.
  • After 1990, patients with lesions of at least 3 cm also received chemotherapy with fluorouracil (1000 mg/m(2)) plus cisplatin (100 mg/m(2)) or mitomycin (10-15 mg/m(2)) if medically fit (n = 26).
  • RT was delivered with a 4-field box technique to deliver 45 Gy in 25 fractions.
  • The inguinal nodes were treated daily using electrons to supplement the dose in that region to a total dose of 45 Gy if clinically negative or about 60 Gy if involved.
  • A 10- to 15-Gy boost was delivered using interstitial iridium 192 implant (n = 32), en face (60)Co field (n = 5), or external-beam photon fields (n = 11).
  • There was an improvement in local control with the addition of chemotherapy in more advanced disease, but it was not significant.
  • There was an increase in acute toxicity with the addition of chemotherapy (12% > or = Grade 4) but not long-term toxicity.
  • Late toxicity requiring colostomy occurred in 6% of patients and consisted of soft tissue necrosis.
  • CONCLUSIONS: The majority of patients with anal canal carcinoma can be treated with curative intent using a sphincter-sparing approach of radiation with or without chemotherapy even with advanced disease.
  • With the addition of chemotherapy to radiation, there is an increased risk of acute toxicity and about 1-2% incidence of toxic death.
  • Smaller tumors (T1 and early T2) probably do not require the addition of chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Anal Canal / physiology. Analysis of Variance. Cisplatin / administration & dosage. Fluorouracil / administration & dosage. Follow-Up Studies. Humans. Middle Aged. Mitomycin / administration & dosage. Neoplasm Staging. Radiotherapy Dosage. Salvage Therapy. Survival Rate. Treatment Outcome

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  • (PMID = 11240241.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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72. Whiteford MH, Stevens KR Jr, Oh S, Deveney KE: The evolving treatment of anal cancer: How are we doing? Arch Surg; 2001 Aug;136(8):886-91
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  • [Title] The evolving treatment of anal cancer: How are we doing?
  • HYPOTHESIS: The adaptation of new techniques in treatment of epidermoid carcinoma of the anal canal during the past 3 decades has improved clinical outcomes.
  • PATIENTS: Medical records of 76 consecutive patients treated for invasive epidermoid cancer of the anal canal between 1970 and 1999 were reviewed.
  • The prevailing primary treatment modality changed during the course of the study from sequential treatment (chemotherapy then radiation therapy then radical surgery) to concurrent chemoradiation (70% and 0% of cases, respectively, in decade 1 to 7% and 76% of cases, respectively, in decade 3).
  • CONCLUSION: Primary treatment with concurrent chemoradiation has improved the local recurrence, survival, and colostomy-free survival rates in patients with invasive epidermoid carcinoma of the anal canal without increasing major morbidity.
  • [MeSH-major] Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Colostomy. Dose Fractionation. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Postoperative Complications / etiology. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 11485523.001).
  • [ISSN] 0004-0010
  • [Journal-full-title] Archives of surgery (Chicago, Ill. : 1960)
  • [ISO-abbreviation] Arch Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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73. Makhdoomi KR, Huntly BJ, Diggory RT: Immunosuppressive drug therapy as a potentiator of anal carcinoma in a patient with relapsing lymphoma. J Pak Med Assoc; 2000 Jan;50(1):37-8
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  • [Title] Immunosuppressive drug therapy as a potentiator of anal carcinoma in a patient with relapsing lymphoma.

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  • (PMID = 10770048.001).
  • [ISSN] 0030-9982
  • [Journal-full-title] JPMA. The Journal of the Pakistan Medical Association
  • [ISO-abbreviation] J Pak Med Assoc
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] PAKISTAN
  • [Chemical-registry-number] 0 / Immunosuppressive Agents
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74. Oblak I, Petric P, Anderluh F, Velenik V, Hudej R, Fras AP: Anal cancer chemoirradiation with curative intent - a single institution experience. Neoplasma; 2009;56(2):150-5
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  • [Title] Anal cancer chemoirradiation with curative intent - a single institution experience.
  • Results of radiochemotherapy in 50 patients with squamous cell carcinoma of the anal canal, treated with radical radiochemotherapy between January 2003 and September 2007, at the Institute of Oncology Ljubljana are presented.
  • The treatment schedule consisted of 3-D conformal external beam radiotherapy (45 Gy in 25 fractions), with two cycles of concurrent chemotherapy (5-fluorouracil (5-FU) / Mitomycin C), followed by brachytherapy or external beam boost (15-30 Gy) to the primary tumor.
  • The impact of individual tumor- and therapy-related factors on treatment outcome was assessed.
  • <p align="justify">Treatment was completed according to the protocol in 72% of patients.
  • The median follow-up time of 40 survivors was 22 months (range 1.7-53.2 months).
  • The most frequent acute side-effect of treatment was radiodermatitis (grade 3 in 66% of patients, grade 4 in 2%).
  • Late anal stenosis, chronic ulceration and grade 2-3 incontinence developed in 3 (6 %), 2 (4 %) and 5 (10 %) of colostomy-free survivors, respectively.
  • </p><p align="justify">Radiotherapy with concurrent 5-FU / Mitomycin C chemotherapy is feasible, with acceptable toxicity.
  • The presented treatment outcome is comparable to other published results.
  • </p> KEYWORDS: anal cancer, radiochemotherapy, survival, toxicity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Brachytherapy. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Prognosis. Radiotherapy Dosage

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  • (PMID = 19239330.001).
  • [ISSN] 0028-2685
  • [Journal-full-title] Neoplasma
  • [ISO-abbreviation] Neoplasma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Slovakia
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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75. Hwang JM, Rao AR, Cosmatos HA, Wang R, Kaptein JS, Kagan RA, Hsiang JY, Tome M: Treatment of T3 and T4 anal carcinoma with combined chemoradiation and interstitial 192Ir implantation: a 10-year experience. Brachytherapy; 2004;3(2):95-100
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  • [Title] Treatment of T3 and T4 anal carcinoma with combined chemoradiation and interstitial 192Ir implantation: a 10-year experience.
  • PURPOSE: To report our experience in treating T3 and T4 anal carcinoma with combined external beam (EBRT) and chemotherapy, followed by interstitial (192)Ir implant boost.
  • METHODS AND MATERIALS: From 1990 to 2000, 31 patients with T3 and T4 anal carcinoma were treated with: 30 Gy EBRT (2 Gy fractions, 5 days/week) + 5-fluorouracil + mitomycin-C.
  • Median implant dose was 31.3 Gy at 0.5 cm, delivered at a mean rate of 0.52 Gy/h.
  • RESULTS: Six patients had local persistence and 4 eventually developed local-regional recurrence.
  • With the addition of APR in selected cases, the ultimate local-regional control after initial treatment was 84%.
  • Eight had radiation proctitis and 7 developed postimplant ulceration.
  • CONCLUSIONS: Treatment of T3 and T4 anal cancer with combined chemotherapy and EBRT, followed by interstitial implant results in an ultimate local-regional control of 84%, after the inclusion of selected APR.
  • [MeSH-major] Antibiotics, Antineoplastic / therapeutic use. Anus Neoplasms / radiotherapy. Brachytherapy. Fluorouracil / therapeutic use. Iridium Radioisotopes / therapeutic use. Mitomycin / therapeutic use

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  • (PMID = 15374541.001).
  • [ISSN] 1538-4721
  • [Journal-full-title] Brachytherapy
  • [ISO-abbreviation] Brachytherapy
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Iridium Radioisotopes; 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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76. Sermier A, Gervaz P, Egger JF, Dao M, Allal AS, Bonet M, Morel P: Lymph node retrieval in abdominoperineal surgical specimen is radiation time-dependent. World J Surg Oncol; 2006;4:29
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  • [Title] Lymph node retrieval in abdominoperineal surgical specimen is radiation time-dependent.
  • BACKGROUND: A low yield of lymph nodes (LN) in abdominoperineal resection (APR) specimen has been associated with preoperative radiation therapy (XRT) in population-based studies, which may preclude adequate staging of anorectal carcinomas.
  • We hypothesized that the number of LN retrieved in APR specimen was correlated with the dose and the timing of pelvic irradiation.
  • 2) Dose of pelvic irradiation; and 3) Time interval between the end of XRT and surgery.
  • There were 12 patients operated for squamous cell carcinoma of the anal canal (SCCA) and 90 for rectal cancer.
  • 83% and 46% of patients with anal and rectal cancer respectively underwent radical/neoadjuvant radiotherapy.
  • The mean +/- SD number of LN in APR specimen was 9.2 +/- 5.9.
  • The mean number of LN in APR specimen was significantly lower in patients who underwent preoperative XRT (8 +/- 5.5 vs. 10.5 +/- 6.1, Mann-Whitney U test, p = 0.02).
  • The mean number of LN was not significantly different after XRT in patients with SCCA than in patients with rectal cancer (6.2 +/- 5.3 vs. 7.8 +/- 5.3, p = 0.33).
  • Finally, there was an inverse correlation between the yield of LN and the time elapsed between XRT and surgery (linear regression coefficient r = -0.32, p = 0.03).
  • 1) radiation therapy affects the yield of LN retrieval in APR specimen;.
  • 2) this impact is time-dependent.
  • These findings have important implications with regard to anatomic-pathological staging of anal and rectal cancers and subsequent decision-making regarding adjuvant chemotherapy.

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  • (PMID = 16749931.001).
  • [ISSN] 1477-7819
  • [Journal-full-title] World journal of surgical oncology
  • [ISO-abbreviation] World J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1524768
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77. Fedorov VD, Odariuk TS, Shelygin IuA: [Long-term result of hemicorporectomy]. Khirurgiia (Mosk); 2000;(2):9-13
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  • The patient was operated several times since 1983 for massive perianal condylomas.
  • In 1985 the ulcer with hard edges was revealed in the perianal region, spreading to the perineum and root of the scrotum.
  • Biopsy data evidenced for epidermoid carcinoma Abdominoperineal extirpation of the rectum was carried out with broad dissection of the skin of the perineum and with resection of the seminal follicle.
  • Postoperative period was complicated by prolonged pyogenous infection of the perineal wound which prevented from radiation treatment.
  • 6 courses of chemotherapy by 5-fluorouracyl were carried out.
  • Hemicorporectomy was carried out with previously layed one-stem sygmostomy keeping intact, and retroperitoneal Y-shaped uretero-ureter anastomosis being formed and right ureter being fixed at the skin of the right abdominal wall.
  • Thus, in spite of a number of complications we can state, that hemicorporectomy has cured the patient of advanced, cancer and he feels satisfied with this treatment and saving 12 years of life.
  • [MeSH-major] Amputation / methods. Carcinoma, Squamous Cell / surgery. Pelvic Neoplasms / surgery
  • [MeSH-minor] Adult. Decision Making. Follow-Up Studies. Humans. Male. Middle Aged. Prostheses and Implants. Retrospective Studies

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  • (PMID = 10710911.001).
  • [ISSN] 0023-1207
  • [Journal-full-title] Khirurgiia
  • [ISO-abbreviation] Khirurgiia (Mosk)
  • [Language] rus
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] RUSSIA
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78. de Parades V, Bauer P, Benbunan JL, Bouillet T, Cottu PH, Cuenod CA, Durdux C, Fléjou JF, Atienza P: [Initial pretherapeutic assessment of anal epidermoid carcinoma]. Gastroenterol Clin Biol; 2007 Feb;31(2):157-65
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  • [Title] [Initial pretherapeutic assessment of anal epidermoid carcinoma].
  • [Transliterated title] Bilan préthérapeutique initial du carcinome épidermoïde invasif de l'anus.
  • Anal epidermoid carcinoma is a rare malignant tumor, comprising less than 5% of all carcinomas of the colon, rectum, and anus.
  • The primary therapy now includes radiotherapy, often in combination with chemotherapy.
  • Therapeutic indications are based on locoregional staging, the presence of visceral metastases and an evaluation of the medical history.
  • In addition, magnetic resonance imaging, positron emission tomography scanning and inguinal sentinel lymph node procedure should play a role in a more selective approach in patients with anal carcinoma.
  • [MeSH-major] Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy

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  • (PMID = 17347624.001).
  • [ISSN] 0399-8320
  • [Journal-full-title] Gastroentérologie clinique et biologique
  • [ISO-abbreviation] Gastroenterol. Clin. Biol.
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 96
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79. Rabbani AN, Zlotecki RA, Kirwan J, George TJ Jr, Morris CG, Rout WR, Mendenhall WM: Definitive radiotherapy for squamous cell carcinoma of the anal canal. Am J Clin Oncol; 2010 Feb;33(1):47-51
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  • [Title] Definitive radiotherapy for squamous cell carcinoma of the anal canal.
  • PURPOSE: To review the outcomes of definitive radiotherapy (RT) alone or combined with chemotherapy (CT) in the treatment of squamous cell carcinoma of the anal canal.
  • Seven patients (10%) developed Radiation Therapy Oncology Group grade 3 late complications and 4 additional patients (6%) experienced grade 4 late complications.
  • The acute toxicity of treatment is significant; the major risk is neutropenia and sepsis.
  • [MeSH-major] Anal Canal / radiation effects. Antineoplastic Agents / therapeutic use. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / radiotherapy. Neoplasm Recurrence, Local / diagnosis
  • [MeSH-minor] Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Neoplasm Staging. Prognosis. Survival Rate. Treatment Outcome


80. Allal AS, Waelchli L, Bründler MA: Prognostic value of apoptosis-regulating protein expression in anal squamous cell carcinoma. Clin Cancer Res; 2003 Dec 15;9(17):6489-96
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  • [Title] Prognostic value of apoptosis-regulating protein expression in anal squamous cell carcinoma.
  • PURPOSE: This study evaluated the prognostic value of pro and antiapoptotic protein expression, as well as that of spontaneous apoptosis, in anal carcinoma patients treated by radiotherapy (RT) with or without chemotherapy.
  • Patients had been treated with split-course RT: 30-40 Gy fractionated external beam, followed by a 20-22-Gy boost using interstitial or external RT.
  • Tissue sections were examined immunohistochemically for expression of proapoptotic proteins (Bax, p53), antiapoptotic proteins (Bcl-2, Mcl-1), and spontaneous apoptosis (M30).
  • RESULTS: For LC, beside advanced T- and N-categories and longer overall treatment time (OTT), lack of Bcl-2 expression was associated with poorer 5-year outcome (62 versus 84%, P = 0.009).
  • For DFS, age (P = 0.049) an N-category (P < 0.0001), as well as expression of Bcl-2 (P = 0.001), p53 (P = 0.003), and M30 (P = 0.03), were found to be independent significant variables.
  • CONCLUSIONS: Bcl-2 and particularly the combination of p53 and Bcl-2 expression may prove to be useful predictors of tumor response to RT or radiochemotherapy in anal carcinomas.
  • Patients having tumors that are Bcl-2(-) and p53(+) may require intensified radiochemotherapy or adoption of an alternative therapeutic approach.
  • [MeSH-major] Anus Neoplasms / diagnosis. Apoptosis. Carcinoma, Squamous Cell / diagnosis. Proto-Oncogene Proteins c-bcl-2 / metabolism
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Disease-Free Survival. Female. Humans. Immunohistochemistry. Male. Middle Aged. Multivariate Analysis. Prognosis. Proportional Hazards Models. Time Factors. Treatment Outcome. Tumor Suppressor Protein p53 / metabolism

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  • (PMID = 14695153.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Proto-Oncogene Proteins c-bcl-2; 0 / Tumor Suppressor Protein p53
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81. Wong S, Gibbs P, Chao M, Jones I, McLaughlin S, Tjandra J, Faragher I, Green M: Carcinoma of the anal canal: a local experience and review of the literature. ANZ J Surg; 2004 Jul;74(7):541-6
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  • [Title] Carcinoma of the anal canal: a local experience and review of the literature.
  • BACKGROUND: Through the 1970s patients presenting with anal canal carcinoma were managed with a surgical approach--abdomino-perineal resection.
  • Since then, the pioneering work of Nigro et al. and a series of large clinical trials have clearly demonstrated that combined chemotherapy and radiotherapy result in greater local control, colostomy-free survival and increase in overall patient survival.
  • METHODS: All patients with anal cancer treated at three tertiary referral centres over an 11-year period (1991-2001) were identified.
  • Of the 46 patients treated for cure, 38 received a combination of chemotherapy and radiation, with 79% achieving a complete response.
  • CONCLUSIONS: Overall this series demonstrates that combined chemotherapy and radiotherapy has been adopted as standard treatment with outcome data similar to those reported in the randomized clinical trials.
  • Where possible elderly patients should receive combined modality therapy.
  • [MeSH-major] Anus Neoplasms / therapy
  • [MeSH-minor] Aged. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Middle Aged. Retrospective Studies. Survival Rate

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  • (PMID = 15230786.001).
  • [ISSN] 1445-1433
  • [Journal-full-title] ANZ journal of surgery
  • [ISO-abbreviation] ANZ J Surg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Australia
  • [Number-of-references] 23
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82. Kinjo A, Ogawa K, Iraha S, Tamaki W, Toita T, Kakinohana Y, Samura H, Kinjo I, Nishimaki T, Kuniyoshi Y, Murayama S: [Concurrent chemoradiotherapy for squamous cell carcinoma of the anal canal-report of four cases]. Gan To Kagaku Ryoho; 2008 Mar;35(3):519-22
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  • [Title] [Concurrent chemoradiotherapy for squamous cell carcinoma of the anal canal-report of four cases].
  • We have treated four Japanese patients with squamous cell carcinoma of the anal canal using concurrent chemoradiotherapy.
  • The chemotherapy consisted of one or two cycles of mitomycin C 10 mg/m(2)/day (intravenous bolus injection) on day 1, and 5-fluorouracil 700 or 1,000 mg/m(2)/day (continuous intravenous infusion) on days 2-5 during radiotherapy.
  • The total radiation dose was 40-54 Gy to the primary lesion.
  • These four patients have been alive and free of disease (follow-ups of 55, 14, 7 and 5 months, respectively), with excellent function of the anal sphincter after treatment.
  • These results suggest that concurrent chemoradiotherapy is safe and effective for Japanese patients with squamous cell carcinoma of the anal canal.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Adult. Aged. Colonoscopy. Combined Modality Therapy / adverse effects. Female. Humans. Magnetic Resonance Imaging. Male. Middle Aged

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  • (PMID = 18347409.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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83. Subramaniam R, Arnott SJ, Leslie MD: Successful chemoradiotherapy for anal cancer despite previous radical radiotherapy for gynaecological malignancy. Clin Oncol (R Coll Radiol); 2002 Aug;14(4):285-6
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  • [Title] Successful chemoradiotherapy for anal cancer despite previous radical radiotherapy for gynaecological malignancy.
  • Repeat radical irradiation of the pelvis is generally not undertaken because of concerns regarding normal tissue damage; in particular to small bowel, bladder and bone.
  • Two patients with carcinoma of the anal canal are presented who had previously been treated by radical pelvic radiotherapy for gynaecological malignancy.
  • Both were re-treated with radical radiotherapy to the pelvis with concomitant chemotherapy.
  • A complete remission of anal cancer was achieved in both patients with minimal acute and late toxicities.
  • [MeSH-major] Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Endometrial Neoplasms / radiotherapy. Endometrial Neoplasms / surgery. Female. Fluorouracil / therapeutic use. Humans. Hysterectomy. Mitomycin / therapeutic use. Remission Induction. Treatment Outcome

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  • (PMID = 12206638.001).
  • [ISSN] 0936-6555
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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84. Crehange G, Bosset M, Lorchel F, Dumas JL, Buffet-Miny J, Puyraveau M, Mercier M, Bosset JF: Combining cisplatin and mitomycin with radiotherapy in anal carcinoma. Dis Colon Rectum; 2007 Jan;50(1):43-9
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  • [Title] Combining cisplatin and mitomycin with radiotherapy in anal carcinoma.
  • PURPOSE: The European Organization for Research and Treatment of Cancer (EORTC) phase II study No. 22953 demonstrated the feasibility of reducing the overall treatment time of chemoradiation, delivering mitomycin C twice rather than once and fluorouracil during the whole treatment.
  • We tested the feasibility of chemoradiation in anal carcinoma with mitomycin and cisplatin in a phase II study.
  • METHODS: Twenty-one patients with locally advanced anal carcinoma (15 women, 6 men) were treated.
  • The first sequence of radiotherapy consisted of 36 Gy over four weeks.
  • After a gap interval of 16 days, a second sequence of radiotherapy was given, delivering 23.4 Gy over 2.5 weeks.
  • Grade > or = 2 acute toxicities of 62, 29, 25, and 5 percent were observed for skin, diarrhea, hematologic, and renal toxicities, respectively.
  • CONCLUSIONS: Combining radiation with mitomycin and cisplatin in patients with locally advanced anal cancer is feasible.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma / drug therapy. Carcinoma / radiotherapy. Cisplatin / administration & dosage. Mitomycin / administration & dosage
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Drug Administration Schedule. Feasibility Studies. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Radiotherapy Dosage. Treatment Outcome

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  • (PMID = 17089083.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin
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85. Weber DC, Nouet P, Kurtz JM, Allal AS: Assessment of target dose delivery in anal cancer using in vivo thermoluminescent dosimetry. Radiother Oncol; 2001 Apr;59(1):39-43
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  • [Title] Assessment of target dose delivery in anal cancer using in vivo thermoluminescent dosimetry.
  • PURPOSE: To measure anal dose during external beam radiotherapy (EBRT) using in vivo dosimetry, to study the difference of measured from prescribed dose values, and to evaluate possible associations of such differences with acute and late skin/mucosal toxicity and anorectal function.
  • MATERIALS: Thirty-one patients with localized anal carcinoma underwent in vivo measurements during the first EBRT session.
  • Themoluminescent dosimeters (TLD) were placed at the center of the anal verge according to a localization protocol.
  • Patients received a median dose of 39.6 Gy (range: 36-45 Gy) by anteroposterior opposed AP/PA pelvic fields with 6 or 18 MV photons, followed by a median boost dose of 20 Gy (range: 13-24 Gy).
  • Concomitant chemotherapy (CCT), consisting of 1-2 cycles of continuous infusion 5-fluorouracil (5-FU) and bolus mitomycin-C (MMC), was usually administered during the first weeks of the pelvic and boost EBRT courses.
  • Acute and late skin/mucosal reactions were recorded according to the Radiation Therapy Oncology Group (RTOG) toxicity scale.
  • Anal sphincter function was assessed using the Memorial Sloan Kettering Cancer Center (MSKCC) scale.
  • RESULTS: TLD anal doses differed by a mean of 5.8% (SD: 5.8) in comparison to the central axis prescribed dose.
  • TLD doses did not significantly correlate with acute or late grade 2-3 skin or mucosal toxicity.
  • However, patients having good-fair MSKCC anal function had a significantly greater mean difference in anal TLD dose (10.5%, SD: 5.9) than patients having excellent function (3.8%, SD: 4.6) (P = 0.004).
  • CONCLUSIONS: These data show that AP/PA fields using megavoltage photons deliver adequate dose to the anal verge.
  • However, in about one quarter of patients treated with this technique the anal dose varied from the prescribed dose by at least 10%.
  • The observed correlation of TLD values and late sphincter function suggests that direct measurement of the dose delivered to the anal verge might be clinically relevant.
  • [MeSH-major] Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / radiotherapy. Radiotherapy Planning, Computer-Assisted / methods. Radiotherapy, High-Energy / methods. Thermoluminescent Dosimetry
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Dose-Response Relationship, Radiation. Female. Follow-Up Studies. Humans. Male. Middle Aged. Probability. Radiation Dosage. Treatment Outcome

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  • (PMID = 11295204.001).
  • [ISSN] 0167-8140
  • [Journal-full-title] Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
  • [ISO-abbreviation] Radiother Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article
  • [Publication-country] Ireland
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86. Sasaoka M, Fuwa N, Matsumoto A, Furutani K, Kamata M, Kodaira T: [Two cases of squamous cell carcinoma of the anal canal treated with chemoradiotherapy]. Gan To Kagaku Ryoho; 2001 Mar;28(3):399-402
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  • [Title] [Two cases of squamous cell carcinoma of the anal canal treated with chemoradiotherapy].
  • We recently treated 2 patients with squamous cell carcinoma in the anal canal with bilateral inguinal nodal metastases using chemoradiotherapy.
  • Chemotherapy (CT) consisted of 5-fluorouracil 700 mg/m2/day (continuous intravenously) on days 1-5 and cisplatin 50 mg/m2/day (continuous intravenously) on days 6-7.
  • Chemotherapy was administered before the beginning of radiotherapy.
  • The total radiation dose was 57.6 Gy to the primary lesion in each patient, and 53.6 Gy, 55.8 Gy to the nodal metastases, respectively.
  • As a primary treatment response, CR was obtained in both patients.
  • The patients have had 7 and 9 months survival without disease, and excellent function of the anal sphincter after treatment.
  • [MeSH-major] Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy
  • [MeSH-minor] Aged. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Middle Aged. Radiotherapy Dosage

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  • (PMID = 11265413.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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87. Di Benedetto G, Siquini W, Bertani A, Grassetti L: Vulvo-perineal reconstruction with a reverse sensitive rectus abdominis salvage flap in a multirecurrent anal carcinoma. J Plast Reconstr Aesthet Surg; 2010 Feb;63(2):e127-9
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  • [Title] Vulvo-perineal reconstruction with a reverse sensitive rectus abdominis salvage flap in a multirecurrent anal carcinoma.
  • We report a case of a patient affected by multirecurrent anal carcinoma, treated by chemotherapy, radiotherapy and surgery several times, until an extended abdominoperineal resection of Miles was performed.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Reconstructive Surgical Procedures / methods. Rectal Neoplasms / surgery. Surgical Flaps. Vulvar Neoplasms / surgery

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  • [Copyright] 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
  • (PMID = 19631598.001).
  • [ISSN] 1878-0539
  • [Journal-full-title] Journal of plastic, reconstructive & aesthetic surgery : JPRAS
  • [ISO-abbreviation] J Plast Reconstr Aesthet Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
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88. Chawla AK, Willett CG: Squamous cell carcinoma of the anal canal and anal margin. Hematol Oncol Clin North Am; 2001 Apr;15(2):321-44, vi
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Squamous cell carcinoma of the anal canal and anal margin.
  • Squamous cell carcinomas of the anal canal and margin are relatively uncommon neoplasms of the distal gastrointestinal tract and surrounding skin.
  • Randomized, phase III trials have defined the standard of care for anal cancer tumors to be a combined modality approach of radiation therapy and chemotherapy.
  • This nonsurgical, organ-sparing regimen results in good anal sphincter function in the majority of patients, and treatment efficacy is favorable when compared with historic surgical series.
  • Anal margin tumors are staged and treated as skin cancers, with a more favorable prognosis.
  • [MeSH-major] Anus Neoplasms. Carcinoma, Squamous Cell

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  • (PMID = 11370496.001).
  • [ISSN] 0889-8588
  • [Journal-full-title] Hematology/oncology clinics of North America
  • [ISO-abbreviation] Hematol. Oncol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 88
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89. Blumetti J, Bastawrous AL: Epidermoid cancers of the anal canal: current treatment. Clin Colon Rectal Surg; 2009 May;22(2):77-83
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  • [Title] Epidermoid cancers of the anal canal: current treatment.
  • Epidermoid carcinoma of the anal canal is an uncommon disease, but has increased in incidence with the HIV epidemic.
  • Prior to the 1970s, treatment consisted of radical surgery with abdominoperineal resection.
  • Norman Nigro, this has shifted to a nonsurgical approach, with primary treatment consisting of multimodality therapy with radiation and chemotherapy.
  • This review provides an overview of the historical, current, and future treatments of epidermoid anal canal malignancies.

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  • (PMID = 20436831.001).
  • [ISSN] 1530-9681
  • [Journal-full-title] Clinics in colon and rectal surgery
  • [ISO-abbreviation] Clin Colon Rectal Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2780240
  • [Keywords] NOTNLM ; Anal canal malignancy / Nigro protocol / chemoradiation / epidermoid carcinoma
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90. Sueda K, Ikenaga M, Miyazaki M, Yasui M, Mishima H, Tsujie M, Omiya H, Miyamoto A, Hirao M, Takami K, Fujitani K, Nakamori S, Yoshida K, Tsujinaka T: [A case of squamous cell carcinoma of the anal cancer with associated human immunodeficiency virus]. Gan To Kagaku Ryoho; 2010 Nov;37(12):2656-8
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  • [Title] [A case of squamous cell carcinoma of the anal cancer with associated human immunodeficiency virus].
  • He presented with an anal tumor with bilateral inguinal nodal metastasis and pain in the anus; the tumor was diagnosed as stage IIIb (cA1N2M0).
  • The patient was administered chemotherapy with 5-fluorouracil and cisplatin (5-FU/CDDP) to the metastatic lymph node.
  • However, the treatment response was graded as progressive disease, and the treatment was changed from CDDP to mitomycin C (MMC).
  • The patient developed non-hematologic toxicity and died within 3 years of the diagnosis.
  • We report a case of squamous cell carcinoma of the anus with associated HIV infection.
  • [MeSH-major] Anus Neoplasms / complications. Anus Neoplasms / therapy. Carcinoma, Squamous Cell / complications. Carcinoma, Squamous Cell / therapy. HIV Seropositivity / complications
  • [MeSH-minor] Antibiotics, Antineoplastic / administration & dosage. Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Agents / administration & dosage. Antineoplastic Combined Chemotherapy Protocols. Antiretroviral Therapy, Highly Active. Cisplatin / administration & dosage. Combined Modality Therapy. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Mitomycin / administration & dosage


91. Das P, Crane CH, Ajani JA: Current treatment for localized anal carcinoma. Curr Opin Oncol; 2007 Jul;19(4):396-400
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  • [Title] Current treatment for localized anal carcinoma.
  • PURPOSE OF REVIEW: Chemoradiation represents the standard of care for most patients with localized squamous cell carcinoma of the anal canal.
  • This article reviews randomized trials and recent studies on chemoradiation for anal cancer.
  • It remains unclear whether this difference in the rate of colostomy was due to the chemotherapy agents, the use of induction therapy in the 5-fluorouracil/cisplatin arm, or other factors.
  • Recent studies have started to evaluate intensity modulated radiation therapy for anal cancer, in an effort to reduce acute and long-term toxicity from radiotherapy.
  • SUMMARY: The role of cisplatin in anal cancer is not completely clear, although an ongoing randomized trial (Anal Cancer Trial II) may help clarify the role of cisplatin.
  • Studies on tumor biology and patient genetics are warranted to identify patients that are most likely to benefit from newer locoregional and systemic therapies.
  • Intensity modulated radiation therapy appears to be a promising approach for reducing treatment-related toxicity in anal cancer patients.
  • The Radiation Therapy Oncology Group (RTOG) is conducting a phase II trial evaluating the multi-institutional feasibility of intensity modulated radiation therapy for anal cancer.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Anus Neoplasms / drug therapy. Carcinoma, Squamous Cell / drug therapy. Cisplatin / therapeutic use. Radiation-Sensitizing Agents / therapeutic use
  • [MeSH-minor] Fluorouracil / therapeutic use. Humans. Mitomycin / therapeutic use. Radiotherapy, Intensity-Modulated

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  • (PMID = 17545807.001).
  • [ISSN] 1040-8746
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Radiation-Sensitizing Agents; 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Number-of-references] 21
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92. Roohipour R, Patil S, Goodman KA, Minsky BD, Wong WD, Guillem JG, Paty PB, Weiser MR, Neuman HB, Shia J, Schrag D, Temple LK: Squamous-cell carcinoma of the anal canal: predictors of treatment outcome. Dis Colon Rectum; 2008 Feb;51(2):147-53
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Squamous-cell carcinoma of the anal canal: predictors of treatment outcome.
  • PURPOSE: The incidence of anal canal squamous-cell carcinoma is increasing.
  • Limited data exist on predictors of treatment failure.
  • This study was designed to identify predictors for relapse/persistence after first-line therapy.
  • METHODS: Using one database, we identified 131 Stages I-III patients treated for primary anal canal squamous-cell carcinoma at our institution from December 1986 to August 2006, with minimum six-month follow-up.
  • Demographic, pathologic, treatment, and outcome data were extracted.
  • Treatment failure was defined as biopsy-proven persistence or relapse (local and/or distant).
  • Although 114 (93.4 percent) completed radiotherapy, most required treatment breaks, making total duration of radiotherapy longer than planned.
  • Almost all patients undergoing radiotherapy (96.7 percent, 118/122) also had chemotherapy: 118 (100 percent, Stages I-III) had concurrent chemotherapy: (98 (83.8 percent) mitomycin/5-fluorouracil, 12 (10.2 percent) cisplatin/5-fluorouracil, 8 (6.8 percent) 5-fluorouracil alone); 35 of 46 (76 percent) Stage III patients received induction chemotherapy (34 (97.1 percent) cisplatin/5-fluorouracil, 1 (2.8 percent) 5-fluorouracil alone).
  • Thirty-seven patients (28.2 percent) failed first-line therapy.
  • Bivariate analyses demonstrated that T stage (P=0.0019), completion of radiotherapy, and total radiotherapy dose (P=0.03) were all significantly associated with treatment failure.
  • CONCLUSIONS: Tolerance of chemoradiation seems to be an important predictor of treatment success.
  • Effective therapies with less acute toxicity must be identified.
  • [MeSH-major] Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biopsy. Combined Modality Therapy / methods. Disease-Free Survival. Endosonography. Female. Follow-Up Studies. Humans. Incidence. Male. Middle Aged. Neoplasm Recurrence, Local / epidemiology. Neoplasm Staging. New York / epidemiology. Retrospective Studies. Survival Rate. Time Factors. Tomography, X-Ray Computed. Treatment Outcome

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  • [ErratumIn] Dis Colon Rectum. 2008 May;51(5):620
  • (PMID = 18180997.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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93. Hatfield P, Cooper R, Sebag-Montefiore D: Involved-field, low-dose chemoradiotherapy for early-stage anal carcinoma. Int J Radiat Oncol Biol Phys; 2008 Feb 1;70(2):419-24
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Involved-field, low-dose chemoradiotherapy for early-stage anal carcinoma.
  • PURPOSE: To report the results of patients with early-stage anal cancer treated using a low-dose, reduced-volume, involved-field chemoradiotherapy protocol.
  • METHODS AND MATERIALS: Between June 2000 and June 2006, 21 patients were treated with external beam radiotherapy (30 Gy in 15 fractions within 3 weeks) and concurrent chemotherapy (bolus mitomycin-C 12 mg/m(2) on Day 1 to a maximum of 20 mg followed by infusion 5-fluorouracil 1,000 mg/m(2)/24 h on Days 1-4).
  • Only 1 patient could not complete treatment (because of Grade 3 gastrointestinal toxicity).
  • CONCLUSION: The results of our study have shown that for patients with anal carcinoma who have residual microscopic or very-small-volume disease, a policy of low-dose, reduced-volume, involved-field chemoradiotherapy produces excellent local control and disease-free survival, with low rates of acute and late toxicity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy / methods. Dose Fractionation. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Neoplasm Staging. Treatment Outcome

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  • (PMID = 17919842.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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94. Glynne-Jones R, Meadows H, Wan S, Gollins S, Leslie M, Levine E, McDonald AC, Myint S, Samuel L, Sebag-Montefiore D, National Cancer Research Institute Anal Sub Group and Colorectal Clinical Oncology Group: EXTRA--a multicenter phase II study of chemoradiation using a 5 day per week oral regimen of capecitabine and intravenous mitomycin C in anal cancer. Int J Radiat Oncol Biol Phys; 2008 Sep 1;72(1):119-26
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  • [Title] EXTRA--a multicenter phase II study of chemoradiation using a 5 day per week oral regimen of capecitabine and intravenous mitomycin C in anal cancer.
  • PURPOSE: 5-Fluorouracil (5-FU) + mitomycin C (MMC)-based chemoradiotherapy is standard treatment for patients with epidermoid anal carcinoma.
  • This phase II trial aimed to determine the feasibility, toxicity, and efficacy of capecitabine, MMC and radiotherapy (RT) in anal cancer patients.
  • METHODS AND MATERIALS: Radiotherapy comprised the schedule of the UK Anal Cancer Trial (ACT) II trial (50.4 Gy in 28 fractions of 1.8 Gy).
  • With MMC (12 mg/m2) on Day 1 and capecitabine on each RT treatment day in two divided doses (825 mg/m2 b.i.d).
  • Compliance with chemotherapy with no dose interruptions or delays was 68%, and with RT was 81%.
  • Eighteen (58%) patients completed both modalities of treatment as planned.
  • There were no treatment-related deaths.
  • CONCLUSIONS: Capecitabine with MMC and RT in with patients anal carcinoma is well tolerated, with minimal toxicity and acceptable compliance.
  • We recommend testing this schedule in future national Phase III studies in anal cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Administration, Oral. Aged. Aged, 80 and over. Capecitabine. Combined Modality Therapy / adverse effects. Combined Modality Therapy / methods. Deoxycytidine / administration & dosage. Deoxycytidine / adverse effects. Deoxycytidine / analogs & derivatives. Diarrhea / etiology. Drug Administration Schedule. Feasibility Studies. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Fluorouracil / analogs & derivatives. Great Britain. Humans. Infusions, Intravenous. Male. Middle Aged. Mitomycin / administration & dosage. Mitomycin / adverse effects. Neoplasm Recurrence, Local. Neutropenia / etiology. Radiotherapy Dosage. Remission Induction

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  • (PMID = 18472366.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; 50SG953SK6 / Mitomycin; 6804DJ8Z9U / Capecitabine; U3P01618RT / Fluorouracil
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95. Engineer R, Mallik S, Mahantshetty U, Shrivastava S: Impact of radiation dose on locoregional control and survival on squamous cell carcinoma of anal canal. Radiother Oncol; 2010 Jun;95(3):283-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Impact of radiation dose on locoregional control and survival on squamous cell carcinoma of anal canal.
  • PURPOSE: To perform a systematic analysis of clinical data of presentation, treatment, outcome, toxicity, survival and other associated prognostic factors of the patients of anal canal who received treatment at our hospital.
  • METHODS AND MATERIALS: The medical records of 257 patients treated with radiotherapy with or without chemotherapy from the year 1985 to 2005 were studied.
  • Similarly T3-4 tumors receiving radiation dose more than 60Gy independently improved the locoregional control, DFS and OAS irrespective of the nodal status and addition of chemotherapy.
  • CONCLUSIONS: Radiation dose of 56-60Gy for T1 and T2 and 65Gy for T3 and T4 tumors along with concurrent chemotherapy is required to achieve better local control, disease-free survival and overall survival, with acceptable toxicity.
  • [MeSH-major] Anal Canal. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / radiotherapy

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  • [Copyright] Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
  • (PMID = 20452695.001).
  • [ISSN] 1879-0887
  • [Journal-full-title] Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
  • [ISO-abbreviation] Radiother Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
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96. Schwarz JK, Siegel BA, Dehdashti F, Myerson RJ, Fleshman JW, Grigsby PW: Tumor response and survival predicted by post-therapy FDG-PET/CT in anal cancer. Int J Radiat Oncol Biol Phys; 2008 May 1;71(1):180-6
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  • [Title] Tumor response and survival predicted by post-therapy FDG-PET/CT in anal cancer.
  • PURPOSE: To evaluate the response to therapy for anal carcinoma using post-therapy imaging with positron emission tomography (PET)/computed tomography and F-18 fluorodeoxyglucose (FDG) and to compare the metabolic response with patient outcome.
  • PATIENTS AND METHODS: This was a prospective cohort study of 53 consecutive patients with anal cancer.
  • All patients underwent pre- and post-treatment whole-body FDG-PET/computed tomography.
  • Patients had been treated with external beam radiotherapy and concurrent chemotherapy.
  • Whole-body FDG-PET was performed 0.9-5.4 months (mean, 2.1) after therapy completion.
  • RESULTS: The post-therapy PET scan did not show any abnormal FDG uptake (complete metabolic response) in 44 patients.
  • Persistent abnormal FDG uptake (partial metabolic response) was found in the anal tumor in 9 patients.
  • The 2-year cause-specific survival rate was 94% for patients with a complete vs. 39% for patients with a partial metabolic response in the anal tumor (p = 0.0008).
  • The 2-year progression-free survival rate was 95% for patients with a complete vs. 22% for patients with a partial metabolic response in the anal tumor (p < 0.0001).
  • CONCLUSIONS: A partial metabolic response in the anal tumor as determined by post-therapy FDG-PET is predictive of significantly decreased progression-free and cause-specific survival after chemoradiotherapy for anal cancer.
  • [MeSH-major] Anus Neoplasms / radiography. Anus Neoplasms / radionuclide imaging. Fluorodeoxyglucose F18. Positron-Emission Tomography / methods. Radiopharmaceuticals. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy / methods. Disease-Free Survival. Female. Humans. Male. Middle Aged. Proportional Hazards Models. Prospective Studies. Survival Rate

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  • (PMID = 17996387.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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97. Fraunholz I, Weiss C, Eberlein K, Haberl A, Rödel C: Concurrent chemoradiotherapy with 5-fluorouracil and mitomycin C for invasive anal carcinoma in human immunodeficiency virus-positive patients receiving highly active antiretroviral therapy. Int J Radiat Oncol Biol Phys; 2010 Apr;76(5):1425-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Concurrent chemoradiotherapy with 5-fluorouracil and mitomycin C for invasive anal carcinoma in human immunodeficiency virus-positive patients receiving highly active antiretroviral therapy.
  • PURPOSE: To report the clinical outcomes of chemoradiotherapy (CRT) for anal carcinoma in human immunodeficiency virus (HIV)-infected patients receiving highly active antiretroviral therapy.
  • PATIENTS AND METHODS: Between 1997 and 2008, 21 HIV-positive patients who were receiving highly active antiretroviral therapy were treated with CRT (50.4 Gy at 1.8 Gy/fraction plus a 5.4-10.8-Gy external boost; 5-fluorouracil, 1,000 mg/m(2), Days 1-4 and 29-32; and mitomycin C, 10 mg/m(2), Days 1 and 29).
  • A retrospective analysis was performed with respect to the tumor response, local control, cancer-specific and overall survival, and toxicity.
  • The immunologic parameters, including pre- and post-treatment CD4 count, viral load, and acquired immunodeficiency syndrome-specific morbidity was recorded during follow-up (median, 53 months; range, 10-99).
  • RESULTS: CRT could be completed in all 21 patients with a reduction in the chemotherapy dose and/or interruption of radiotherapy in 5 and 5 cases, respectively.
  • Six patients (29%) died, 5 of cancer progression and 1 of treatment-related toxicity.
  • The 5-year local control, cancer-specific, and overall survival rate was 59%, 75%, and 67%, respectively.
  • CONCLUSION: Our data have confirmed that in the highly active antiretroviral therapy era, HIV-related anal cancer can be treated with standard CRT without dose reductions.
  • [MeSH-major] Anti-HIV Agents / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Antiretroviral Therapy, Highly Active. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. HIV Infections / drug therapy
  • [MeSH-minor] Adult. Aged. CD4 Lymphocyte Count. Combined Modality Therapy / adverse effects. Combined Modality Therapy / methods. Disease Progression. Dose Fractionation. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Radiotherapy, Conformal / methods. Remission Induction. Retrospective Studies. Survival Analysis. Viral Load


98. Pelletier F, Drobacheff-Thiebaut C, Aubin F, Venier AG, Mougin C, Laurent R: [Effects of imiquimod on latent human papillomavirus anal infection in HIV-infected patients]. Ann Dermatol Venereol; 2004 Nov;131(11):947-51
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Effects of imiquimod on latent human papillomavirus anal infection in HIV-infected patients].
  • [Transliterated title] Effets de l'imiquimod sur l'infection périanale latente à papillomavirus humain chez des malades infectés par le virus de l'immunodéficience humaine.
  • INTRODUCTION: High risk human papillomaviruses (HPV) have emerged as risk factors for anal carcinoma particularly in HIV-infected patients who demonstrate a high rate of anal HPV infection.
  • Considering the relationship between the presence of anal infection and the development of neoplastic lesions, we wished to assess the capacity of imiquimod to eradicate latent HPV infection in HIV-infected patients.
  • Two consecutive anal swabs were taken at 2 month intervals and only patients with two consecutive tests positive for the detection of HPV-DNA (Hybrid Capture II) were included.
  • HPV-DNA presence was then investigated 2 and 4 months following the onset of treatment.
  • There was no significant difference between treatment groups according to the following criteria: gender, route of HIV transmission, CDC stage, prior medical history of sexually transmitted diseases or anogenital warts.
  • In spite of the low number of treated patients, we did not observe a statistically significant decrease in HPV-DNA in anal swabs from imiquimod-treated patients as compared to placebo-treated patients.
  • [MeSH-major] Adjuvants, Immunologic / pharmacology. Aminoquinolines / pharmacology. HIV Infections / complications. Papillomavirus Infections / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Anus Diseases / drug therapy. Anus Diseases / virology. Anus Neoplasms / prevention & control. Anus Neoplasms / virology. Carcinoma / prevention & control. Carcinoma / virology. Double-Blind Method. Female. Humans. Male. Middle Aged. Prospective Studies. Risk Factors

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  • (PMID = 15602380.001).
  • [ISSN] 0151-9638
  • [Journal-full-title] Annales de dermatologie et de vénéréologie
  • [ISO-abbreviation] Ann Dermatol Venereol
  • [Language] fre
  • [Publication-type] Clinical Trial; English Abstract; Journal Article; Randomized Controlled Trial
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / Aminoquinolines; 99011-02-6 / imiquimod
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99. Nahas CS, Shia J, Joseph R, Schrag D, Minsky BD, Weiser MR, Guillem JG, Paty PB, Klimstra DS, Tang LH, Wong WD, Temple LK: Squamous-cell carcinoma of the rectum: a rare but curable tumor. Dis Colon Rectum; 2007 Sep;50(9):1393-400
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  • [Title] Squamous-cell carcinoma of the rectum: a rare but curable tumor.
  • PURPOSE: This study was designed to evaluate one institution's experience with treatment outcomes for rectal squamous-cell carcinoma.
  • METHODS: Using our prospective Colorectal Database, we identified patients diagnosed with rectal squamous-cell carcinoma at our institution between 1983 and 2005.
  • Pathology was rereviewed, tumor immunophenotype was compared to control cases of anal squamous-cell carcinoma and rectal adenocarcinoma, treatment modalities and outcomes were analyzed.
  • Median distal extent of tumors was 7 (range, 5-8) cm from the anal verge.
  • Treatment included chemotherapy only (n = 1), chemoradiation only (n = 2), induction chemotherapy followed by chemoradiation and surgery (n = 2), chemoradiation followed by surgery (n = 5), and surgery followed by chemoradiation (n = 2).
  • The chemotherapy regimen was 5-fluorouracil-based.
  • Radiotherapy total dose was 50.4 Gy (1.8 Gy/day, daily x 5) external iliac and inguinal nodes were not included in the radiation field.
  • Complete clinical responders to chemoradiation (n = 2) received no further treatment.
  • Immunophenotypical analysis showed similar keratin expression profile between rectal squamous-cell carcinoma (n = 5) and rectal adenocarcinoma (n = 5), which is different from anal squamous-cell carcinoma (n = 10).
  • CONCLUSIONS: Our data suggest that most patients treated with upfront chemoradiation therapy followed by surgery did well.
  • Immunohistochemistry suggests a common cellular origin for rectal squamous-cell carcinoma and rectal adenocarcinoma, which is different from anal squamous-cell carcinoma.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Carcinoma, Squamous Cell / therapy. Colectomy. Fluorouracil / therapeutic use. Rectal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / metabolism. Female. Follow-Up Studies. Humans. Immunohistochemistry. Keratins / metabolism. Male. Middle Aged. Neoplasm Staging. Prospective Studies. Radiotherapy, Adjuvant. Survival Rate. Treatment Outcome. United States / epidemiology

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  • (PMID = 17661147.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Biomarkers, Tumor; 68238-35-7 / Keratins; U3P01618RT / Fluorouracil
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100. Rabbitt P, Pathma-Nathan N, Collinson T, Hewett P, Rieger N: Sentinel lymph node biopsy for squamous cell carcinoma of the anal canal. ANZ J Surg; 2002 Sep;72(9):651-4
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  • [Title] Sentinel lymph node biopsy for squamous cell carcinoma of the anal canal.
  • BACKGROUND: The current Trans-Tasman Radiation Oncology Group (TROG) protocol for T1 and T2 anal cancers is combination chemotherapy and radiotherapy excluding the inguinal region from the field.
  • We have developed a method of sampling the sentinel node in the groin using established node mapping techniques.
  • METHODS: A combination of radio-labelled Antimony Sulphide and Patent Blue dye injected around the anal cancer enable identification of the sentinel node in the groin, using a gamma probe and direct visualization of the blue node.
  • CONCLUSIONS: The application of this effective technique will allow accurate staging of anal cancers to better plan future treatment regimes.
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma, Squamous Cell / pathology. Sentinel Lymph Node Biopsy / methods

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  • (PMID = 12269917.001).
  • [ISSN] 1445-1433
  • [Journal-full-title] ANZ journal of surgery
  • [ISO-abbreviation] ANZ J Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
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