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1. 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.

  • MedlinePlus Health Information. consumer health - Anal Cancer.
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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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2. Cho BC, Ahn JB, Seong J, Roh JK, Kim JH, Chung HC, Sohn JH, Kim NK: Chemoradiotherapy with or without consolidation chemotherapy using cisplatin and 5-fluorouracil in anal squamous cell carcinoma: long-term results in 31 patients. BMC Cancer; 2008;8:8
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  • [Title] Chemoradiotherapy with or without consolidation chemotherapy using cisplatin and 5-fluorouracil in anal squamous cell carcinoma: long-term results in 31 patients.
  • BACKGROUND: The objectives of this study were to evaluate long-term results of concurrent chemoradiotherapy (CRT) with 5-fluorouracil and cisplatin and the potential benefit of consolidation chemotherapy in patients with anal squamous cell carcinoma (ASCC).
  • Radiotherapy was administered at 45 Gy over 5 weeks, followed by a boost of 9 Gy to complete or partial responders.
  • Chemotherapy consisted of 5-fluorouracil (750 or 1,000 mg/m2) daily on days 1 to 5 and days 29 to 33; and, cisplatin (75 or 100 mg/m2) on day 2 and day 30.
  • Twenty-one (67.7%) received consolidation chemotherapy with the same doses of 5-fluorouracil and cisplatin, repeated every 4 weeks for maximum 4 cycles.
  • RESULTS: Nineteen patients (90.5%) completed all four courses of consolidation chemotherapy.
  • No differences in 5-year OS and DFS rates between patients treated with CRT alone and CRT with consolidation chemotherapy was observed.
  • CONCLUSION: our study shows that CRT with 5-FU and cisplatin, with or without consolidation chemotherapy, was well tolerated and proved highly encouraging in terms of long-term survival and the preservation of anal function in ASCC.
  • Further trials with a larger patient population are warranted in order to evaluate the potential role of consolidation 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. Cisplatin / therapeutic use. Fluorouracil / therapeutic use
  • [MeSH-minor] Adult. Aged. Disease-Free Survival. Dose-Response Relationship, Drug. Dose-Response Relationship, Radiation. Female. Follow-Up Studies. Humans. Male. Middle Aged. Survival Rate. Time Factors. Treatment Outcome

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  • (PMID = 18194582.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ PMC2245963
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3. 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

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  • (PMID = 17823743.001).
  • [ISSN] 0104-4230
  • [Journal-full-title] Revista da Associação Médica Brasileira (1992)
  • [ISO-abbreviation] Rev Assoc Med Bras (1992)
  • [Language] por
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Brazil
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4. 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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5. 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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6. 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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7. 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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8. 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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9. Place RJ, Gregorcyk SG, Huber PJ, Simmang CL: Outcome analysis of HIV-positive patients with anal squamous cell carcinoma. Dis Colon Rectum; 2001 Apr;44(4):506-12
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  • [Title] Outcome analysis of HIV-positive patients with anal squamous cell carcinoma.
  • PURPOSE: With improved antiretroviral therapy, HIV-positive patients are achieving a longer life expectancy.
  • An increased incidence of anal squamous cell carcinomas has been noted in these patients.
  • The purpose of this study was to determine the outcome of HIV-positive patients with anal squamous cell carcinomas.
  • We identified 73 patients with anal squamous cell carcinoma treated at the University of Texas Southwestern Medical Center affiliated hospitals; 23 were HIV positive (18 had AIDS).
  • In the HIV-positive group, 9 had in situ squamous carcinomas and 14 had invasive squamous cell carcinomas.
  • Data collected included age, CD4 count, treatment, complications, and survival; these data were analyzed by Student's t-test.
  • Those with squamous cell cancer of the anus were offered radiation therapy and chemotherapy.
  • Beginning in 1998, all patients received highly active antiretroviral therapy before treatment.
  • Seven of 14 anal squamous cell carcinoma patients had their therapy adjusted owing to toxicity.
  • Mean age was 42 years for anal squamous cell carcinoma patients and 36 years for squamous cell carcinoma in situ patients (P = 0.05).
  • Mean CD4 count was 222 cells/ml in patients with infiltrating carcinoma and 200 in the in situ patients (P = NS).
  • One-year and five-year mortality rates, respectively, were 40 percent and 80 percent for infiltrating carcinoma patients and 17 percent and 50 percent for the in situ patients.
  • Both of the in situ patients who died had CD4 counts <20 cells/ml at diagnosis, whereas the rest had CD4 counts >100 cells/ml and are currently without anal disease.
  • Eight (all with infiltrating carcinoma) of the 10 patients who died had persistent anal disease, but none had metastasis.
  • A low CD4 count at diagnosis without highly active antiretroviral therapy predicts a poor prognosis.
  • Because these patients appear to succumb to their HIV status and not the anal disease, anal squamous cell carcinoma should be included with cervical squamous cell carcinoma as an AIDS-defining illness.
  • HIV-positive patients, particularly AIDS patients, with invasive anal cancers and without effective antiretroviral therapy obtain little benefit and significant toxicity from current radiation therapy and chemotherapy.
  • Initiation of highly active antiretroviral therapy in HIV-positive patients before radiation therapy and chemotherapy are begun may decrease toxicity and improve survival.
  • [MeSH-major] Anus Neoplasms / complications. Carcinoma in Situ / complications. Carcinoma, Squamous Cell / complications. HIV Infections / complications
  • [MeSH-minor] Adult. Antiretroviral Therapy, Highly Active. CD4 Lymphocyte Count. Combined Modality Therapy. Humans. Male. Middle Aged. Prognosis. Retrospective Studies. Survival Analysis. Treatment Outcome


10. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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11. 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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12. 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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13. 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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14. 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

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  • (PMID = 19704368.001).
  • [ISSN] 1537-453X
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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15. Eng C, Chang GJ, Das P, Rodriguez-Bigas M, Skibber JM, Qiao W, Rosner GL, Ukegbu LT, Wolff RA, Crane CH: Phase II study of capecitabine and oxaliplatin with concurrent radiation therapy (XELOX-XRT) for squamous cell carcinoma of the anal canal. J Clin Oncol; 2009 May 20;27(15_suppl):4116

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase II study of capecitabine and oxaliplatin with concurrent radiation therapy (XELOX-XRT) for squamous cell carcinoma of the anal canal.
  • : 4116 Background: Definitive therapy for squamous cell carcinoma (SCC) of the anal canal consists of external beam radiotherapy with concurrent 5-fluorouracil and mitomycin C or cisplatin.
  • The purpose of this study was to evaluate the tolerability and efficacy of XELOX-XRT as definitive treatment for anal cancer.
  • Primary objectives were time to treatment failure and occurrence of treatment-related toxicity.
  • METHODS: Patients with histologically proven SCC of the anal canal, AJCC Stage II-IIIB (T<sub>2-4</sub> or N+M<sub>0</sub>), ECOG PS 0-1, HIV<sup>-</sup>, and no prior therapy were eligible for XELOX-based chemoradiotherapy.
  • Chemotherapy initially consisted of capecitabine (825 mg/m<sup>2</sup>) BID, M-F and weekly oxaliplatin (50 mg/m<sup>2</sup>) (Group 1) with subsequent modification to omission of chemotherapy during weeks 3 and 6 (Group 2).
  • Radiation therapy was provided in the following manner: T<sub>1</sub> (45 Gy in 25 fractions), T<sub>2</sub> (55 Gy in 30 fractions), and T<sub>3-4</sub> (59 Gy in 32 fractions).
  • Intensity-modulated radiation therapy (IMRT) was allowed.
  • Interim safety analysis was conducted 3 months after the 10<sup>th</sup> pt.
  • Five of 11 (45%) patients developed grade 3 treatment-related diarrhea (Group 1).
  • Therefore, the chemotherapy schedule was modified and only 1 of 9 patients in Group 2 developed grade 3 diarrhea.
  • One patient in Group 1 developed distant failure.
  • After a median follow-up of 19 months, no patient has developed local recurrence or required salvage resection with colostomy for a colostomy-free rate of 100%.
  • CONCLUSIONS: The combination of capecitabine, oxaliplatin, and radiation therapy (XELOX-XRT) is effective for locally advanced squamous cell carcinoma of the anal canal.

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  • (PMID = 27961220.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Swampillai A, Williams M, Osborne M, Mawdsley S, Hughes R, Harrison M, Glynne-Jones R: A single-center study of the utility of squamous cell carcinoma antigen (SCCAg) levels in epidermoid carcinoma of the anal canal and margin (ECACM) treated with chemoradiation (CRT). J Clin Oncol; 2009 May 20;27(15_suppl):4117

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A single-center study of the utility of squamous cell carcinoma antigen (SCCAg) levels in epidermoid carcinoma of the anal canal and margin (ECACM) treated with chemoradiation (CRT).
  • All 195 were treated with CRT- (50.4Gy in 28 fractions of 1.8 Gy with 5-fluorouracil (5-FU) + mitomycin (MMC).
  • Radiotherapy comprised the schedule of the UK Anal cancer Trial (ACT II).
  • 30 had neo-adjuvant chemotherapy followed by CRT and 3 pts had planned surgery followed by CRT.

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  • (PMID = 27961219.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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17. Hammad N, Philip PA, Shields AF, Heilbrun LK, Venkatramanamoorthy R, El-Rayes BF: A retrospective review of squamous cell carcinoma of the anal canal in HIV-positive and HIV-negative patients. J Clin Oncol; 2009 May 20;27(15_suppl):e15586

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A retrospective review of squamous cell carcinoma of the anal canal in HIV-positive and HIV-negative patients.
  • : e15586 Background: Human immunodeficiency virus (HIV) infected patients (pts) are at increased risk for squamous cell carcinoma of the anal canal (SCCAC) and the incidence of SCCAC has increased in the era of HAART (highly active antiretroviral therapy).
  • The aim of this study is to describe the outcome, tolerability, and overall survival (OS) in pts with and without HIV infection treated at Karmanos Cancer Institute, at Wayne State University from 1991 to 2007.
  • We collected data regarding HIV status, demographics (age, gender, race), stage at diagnosis, treatment, response to treatment, toxicity, and survival.
  • HIV (+) pts had significantly better stage (p = 0.011) and less frequent reduced chemotherapy dose (p = 0.001).
  • There were no significant differences by HIV status in type of chemotherapy received, frequency of reduced radiotherapy dosage, use of diverting colostomy, or frequency of relapse.
  • The major toxicities observed in HIV (+) and (-) pts were diarrhea (36% vs. 64%), neutropenia (27% vs. 21%), and skin toxicity secondary to radiotherapy (XRT: 82% vs. 100%; p = 0.034).
  • CONCLUSIONS: HIV (+) pts had better stage, received standard chemotherapy dose more often, and had more frequent XRT dermatitis than HIV (-) pts.
  • Otherwise, there was no major difference in treatment toxicities.

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  • (PMID = 27962344.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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18. Crehange G, Bosset M, Lorchel F, Buffet-Miny J, Puyraveau M, Mercier M, Bosset JF: Chemoradiation in anal carcinoma using a combination of Mitomycin C (MMC) and cisplatin (CDDP): a feasibility study. J Clin Oncol; 2004 Jul 15;22(14_suppl):4079

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Chemoradiation in anal carcinoma using a combination of Mitomycin C (MMC) and cisplatin (CDDP): a feasibility study.
  • : 4079 Background: In anal cancer, the EORTC 22953 phase II study established the feasibility of the following treatment scheme: first sequence: 36 Gy over 4 weeks (large volume), 5-FU infusion 200 mg/m2/d1-d26, MMC 10 mg/m2/d1.
  • Then 23.4 Gy over 17 days (small volume), 5-FU 200 mg/m2/d1-d17, MMC 10 mg/m2/d1.
  • Because it appeared highly effective with few acute and late toxic effects, this scheme is considered as standard by EORTC (Bosset Eur J Cancer 2003).
  • Treatment delivered as an out-patient basis.
  • Four pts did not receive chemotherapy at the second sequence for the following reasons: MMC: 1 pt by omission; CDDP and MMC: 3 pts due to toxicities.
  • ≥ Grade 2 acute toxicity: vomits: 2 pts; granulopenia: 3 pts; anemia: 2 pts; nephrotoxicity: 1 pt; diarrhoea: 4 pts; perineal skin: 10 pts .
  • Eight weeks after treatment, 15 pts were in CR among 16 evaluable pts.
  • CONCLUSIONS: Combining Radiation, MMC and CDDP for the treatment of anal cancer is feasible.
  • The on-going EORTC phase II-III chemoradiation trial is comparing 5-FU-MMC vs CDDP-MMC as the chemotherapy component, the radiation being identical in both arms.

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  • (PMID = 28014460.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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19. Stadler RF, Gregorcyk SG, Euhus DM, Place RJ, Huber PJ, Simmang CL: Outcome of HIV-infected patients with invasive squamous-cell carcinoma of the anal canal in the era of highly active antiretroviral therapy. Dis Colon Rectum; 2004 Aug;47(8):1305-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Outcome of HIV-infected patients with invasive squamous-cell carcinoma of the anal canal in the era of highly active antiretroviral therapy.
  • PURPOSE: Before the development of highly active antiretroviral therapy for the treatment of HIV infection, HIV patients diagnosed with invasive squamous-cell carcinoma of the anal canal carried a very poor prognosis.
  • This study was designed to determine the outcome in a similar group of patients in the era of highly active antiretroviral therapy.
  • METHODS: HIV-positive patients treated for invasive squamous-cell carcinoma of the anal canal at the University of Texas Medical Center affiliated hospitals from 1980 to 2001 were identified from operative data and cancer registries.
  • We reviewed these records and collected data regarding age, CD4 count, highly active antiretroviral therapy, cancer treatment, complications, and survival.
  • The patients were divided into two groups based on the presence or absence of highly active antiretroviral therapy and compared using a Kaplan-Meier approach.
  • RESULTS: Fourteen patients with HIV and invasive squamous-cell carcinoma of the anal canal were identified.
  • Six were in the prehighly active antiretroviral therapy group and eight in the highly active antiretroviral therapy group.
  • All were considered for treatment with chemotherapy and radiation.
  • In the prehighly active antiretroviral therapy group, one patient refused therapy and three were unable to complete the squamous-cell carcinoma therapy as planned because of complications.
  • Four of eight highly active antiretroviral therapy patients were unable to complete the squamous-cell carcinoma therapy as planned.
  • The prehighly active antiretroviral therapy patients had a mean age of 40 years and a mean CD4 count of 190 at the time of diagnosis.
  • The highly active antiretroviral therapy patients had a mean age of 44 years and a mean CD4 count of 255 at the time of diagnosis.
  • The 24-month survival was 17 percent in the prehighly active antiretroviral therapy group and 67 percent in the highly active antiretroviral therapy group (P = 0.0524).
  • All six patients in the prehighly active antiretroviral therapy group died with active squamous-cell carcinoma vs. two in the highly active antiretroviral therapy group.
  • Four of the remaining six patients had no evidence of active squamous-cell carcinoma at the last follow-up visit.
  • CONCLUSIONS: A review of patients with HIV and invasive squamous-cell carcinoma of the anal canal suggests a trend toward a higher CD4 count at the time of diagnosis and improved survival in patients receiving highly active antiretroviral therapy.
  • In this new era, HIV-positive patients should be on highly active antiretroviral therapy.
  • If not, highly active antiretroviral therapy should be initiated, and standard multimodality therapies for invasive squamous-cell carcinoma of the anal canal are recommended.
  • [MeSH-major] Antiretroviral Therapy, Highly Active. Anus Neoplasms / pathology. Anus Neoplasms / therapy. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / therapy. HIV Infections / complications
  • [MeSH-minor] Adult. CD4 Lymphocyte Count. Combined Modality Therapy. Follow-Up Studies. Humans. Male. Middle Aged. Prognosis. Retrospective Studies. Survival Analysis. Treatment Outcome


20. 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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21. 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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22. 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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23. 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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24. 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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25. 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

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  • [Copyright] Copyright 2004 Wiley-Liss, Inc.
  • (PMID = 15112245.001).
  • [ISSN] 0022-4790
  • [Journal-full-title] Journal of surgical oncology
  • [ISO-abbreviation] J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; CF regimen
  • [Number-of-references] 36
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26. 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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27. 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

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  • (PMID = 19727729.001).
  • [ISSN] 1432-0843
  • [Journal-full-title] Cancer chemotherapy and pharmacology
  • [ISO-abbreviation] Cancer Chemother. Pharmacol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / KRAS protein, human; 0 / Proto-Oncogene Proteins; EC 2.7.10.1 / Receptor, Epidermal Growth Factor; EC 3.6.5.2 / ras Proteins
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28. 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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29. 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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30. Sato H, Maeda K, Koide Y, Matsuoka H, Noro T, Honda K, Shiota M, Endo T, Ozeki S, Fukuda M: [Four cases of anal squamous cell carcinoma treated by chemoradiotherapy]. Gan To Kagaku Ryoho; 2010 Nov;37(12):2647-9
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  • [Title] [Four cases of anal squamous cell carcinoma treated by chemoradiotherapy].
  • We reviewed clinical records of 4 cases with squamous cell carcinoma in anus to evaluate the clinical effectiveness of the chemoradiotherapy.
  • The radiation therapy consisted of 40 Gy was delivered to pelvis and bilateral inguinal lesion, and perianal booster dose of 20 Gy, in fractions of 2.0 Gy per day, was given five days a week.
  • On the first day of radiation therapy, 750 mg/m2 of 5-FU in the form of a continuous 24-hour infusion for 5 days was given.
  • On the first day of chemotherapy, 10 mg/m2 of MMC was also given as a single bolus infusion.
  • 5-FU and MMC were administered 4 times every 4 weeks.
  • All patients had complete response in the anal lesion after chemoradiotherapy.
  • No patients had any sign of recurrence in anal lesion.
  • Chemoradiotherapy was expected to be a safe and effective treatment to improve prognosis for anal squamous carcinoma.
  • [MeSH-major] Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy
  • [MeSH-minor] Adult. Antibiotics, Antineoplastic / administration & dosage. Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Radiation Dosage. Treatment Outcome

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  • (PMID = 21224667.001).
  • [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
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antimetabolites, Antineoplastic; 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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31. Jiang Y, Mackley H, Cheng H, Ajani JA: Anal carcinoma therapy: can we improve on 5-fluorouracil/mitomycin/radiotherapy? J Natl Compr Canc Netw; 2010 Jan;8(1):135-44
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  • [Title] Anal carcinoma therapy: can we improve on 5-fluorouracil/mitomycin/radiotherapy?
  • Use of definitive chemoradiation as primary therapy for locoregional squamous cell carcinoma of the anal canal has been the standard approach in the United States since the 1980s.
  • Two recent phase III studies using diverse treatment strategies showed that cisplatin and 5-FU were not superior to 5-FU and MMC; in one of the trials, use of cisplatin-based chemoradiation resulted in a higher rate of colostomy compared with mitomycin-based chemoradiation.
  • Further improvement is likely depending on an increased understanding of the molecular biology of anal carcinoma and the addition of relevant biologic agents to chemoradiation to overcome chemoradiation resistance.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy
  • [MeSH-minor] Combined Modality Therapy. Fluorouracil / administration & dosage. Humans. Mitomycin / administration & dosage. Treatment Outcome

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  • (PMID = 20064295.001).
  • [ISSN] 1540-1405
  • [Journal-full-title] Journal of the National Comprehensive Cancer Network : JNCCN
  • [ISO-abbreviation] J Natl Compr Canc Netw
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
  • [Number-of-references] 38
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32. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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33. 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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  • [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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34. 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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35. Khanfir K, Ozsahin M, Bieri S, Cavuto C, Mirimanoff RO, Zouhair A: Patterns of failure and outcome in patients with carcinoma of the anal margin. Ann Surg Oncol; 2008 Apr;15(4):1092-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Patterns of failure and outcome in patients with carcinoma of the anal margin.
  • BACKGROUND: To evaluate the outcome of patients with carcinoma of anal margin in terms of recurrence, survival, and radiation toxicity.
  • METHODS: A series of 45 consecutive patients, with anal margin carcinoma treated between 1983 and 2006 with curative intent at two institutions, was retrospectively analyzed.
  • A surgical excision (close or positive surgical margin in 22 out of 29 patients) was realized before radiotherapy (RT).
  • RT consisted of definitive external beam RT (EBRT) in 36 patients, brachytherapy (BT) alone in two patients, and both BT and EBRT in seven patients.
  • The median total radiation dose was 59.4 Gy (range, 30-74 Gy).
  • The overall anal conservation rate was 80% for the whole series.
  • There was no significant association between local recurrence and patient age, histological grade, tumor size, T stage, overall treatment time, RT dose, or chemotherapy.
  • Only three patients developed grade 3-4 late toxicity (CTCAE/NCI v3.0).
  • Significant relationship was found between dose, and complication rate (48% for dose >or=59.4 Gy versus 8% for dose < 59.4 Gy; P = 0.03).
  • CONCLUSIONS: We conclude that definitive RT and/or BT yield a good local control and disease-specific survival comparable with published data.
  • This study suggests that radiation dose over 59.4 Gy seems to increase treatment-related morbidity.
  • [MeSH-major] Anus Neoplasms / therapy. Carcinoma, Basal Cell / therapy. Carcinoma, Squamous Cell / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Anal Canal / surgery. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / epidemiology. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Treatment Failure. Treatment Outcome

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  • (PMID = 18231838.001).
  • [ISSN] 1534-4681
  • [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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36. Oehler-Jänne C, Huguet F, Provencher S, Seifert B, Negretti L, Riener MO, Bonet M, Allal AS, Ciernik IF: HIV-specific differences in outcome of squamous cell carcinoma of the anal canal: a multicentric cohort study of HIV-positive patients receiving highly active antiretroviral therapy. J Clin Oncol; 2008 May 20;26(15):2550-7
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  • [Title] HIV-specific differences in outcome of squamous cell carcinoma of the anal canal: a multicentric cohort study of HIV-positive patients receiving highly active antiretroviral therapy.
  • PURPOSE: To define clinical outcome after definitive chemoradiotherapy (CRT) of anal carcinoma in HIV-infected patients treated with highly active antiretroviral therapy (HAART).
  • Local disease control (LC), relapse-free survival (RFS), overall survival (OS), cancer-specific survival (CSS), toxicity, and prognostic factors were investigated.
  • RESULTS: HIV-positive patients were younger (mean age, 48 v 62 years; P < .0005), predominantly male (93% v 25%; P < .0005), and with early-stage (P = .06) and large-cell histology (90% v 67%; P = .005) disease.
  • Grade 3/4 acute skin (35% v 17% [HIV negative]; P = .04) and hematologic (33% v 12% [HIV negative]; P = .08) toxicity together approximated 50% in HIV-positive patients.
  • RFS in HIV-positive patients was associated with RT dose (P = .08) and severe acute skin toxicity (P = .04).
  • CONCLUSION: Long-term LC and acute toxicity represent major clinical challenges in HIV-positive patients with anal carcinoma.
  • Even if fluoropyrimidine-based CRT is feasible and may result in similar response rates and OS as in HIV-negative patients, improved treatment strategies with better long-term outcome are warranted.
  • [MeSH-major] Antiretroviral Therapy, Highly Active. Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy. HIV Infections / drug therapy
  • [MeSH-minor] Adult. Aged. Cohort Studies. Combined Modality Therapy. Disease-Free Survival. Humans. Male. Middle Aged. Prognosis. Retrospective Studies. Survival Rate. Treatment Outcome


37. Stojanović S, Jelić LjR: Radical radiotherapy in the treatment of carcinoma of the anal canal - single center experience. J BUON; 2004 Jul-Sep;9(3):269-73

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Radical radiotherapy in the treatment of carcinoma of the anal canal - single center experience.
  • PURPOSE: Radiotherapy -/+ chemotherapy is the first-line treatment for carcinoma of the anal canal in most oncology institutions.
  • The aim of our study was to evaluate the efficacy and toxicity of radical radiotherapy in the treatment of this carcinoma.
  • PATIENTS AND METHODS: Definitive radiotherapy was performed in 41 patients with squamous cell anal carcinoma.
  • The total tumor dose ranged from 55-75 Gy.
  • RESULTS: Acute complications were noticed in 32 (78%) patients with moist skin perineal desquamation being the most frequent (63.5%).
  • With a mean follow- up time of 38.4 months (range 12-90 months) 75.6% of the patients were disease-free, while local or distant disease progression was diagnosed in 24.4% of them.
  • CONCLUSION: Our study confirmed good treatment results and acceptable toxicity of definitive radiotherapy in the treatment of anal canal carcinoma.

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  • (PMID = 17415825.001).
  • [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
  • [Publication-country] Greece
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38. Vorob'ëv GI, Odariuk TS, Orlova LP, Nechushkin MI, Rybakov EG: [Prognosis of epidermoid anal carcinoma regression after conservative treatment]. Vopr Onkol; 2004;50(6):663-7
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  • [Title] [Prognosis of epidermoid anal carcinoma regression after conservative treatment].
  • [Transliterated title] Prognoz regressii opukholi pri konservativnoĭ terapii épidermoidnogo raka anal'nogo kanala.
  • The prospective study was concerned with definition of the clinical and therapeutic factors behind poor response of anal cancer to radio- (RT) or chemoradiotherapy (CRT).
  • Out of 64 female and 8 male patients at the mean age of 57 (33-81), thirty six had split-course of 60-65 Gy (RT), twenty--60-65 Gy, 5-FU and mitomycin C (CRT) and eighteen--up to 55-65 Gy (1.5 Gy--session 1, 1.0 Gy--session 2) (hyper-fractionated RT) plus 5-FU, for squamous cell anal carcinoma.
  • There were no tumors confined to the subendothelial layer of the anal canal (uT1); 24 (32.4%) tumors were confined to the internal anal sphincter (uT2); 19 (25.7%) invaded the external anal sphincter (uT3) and 31 (41.9%)--levator ani (uT4).
  • ERUS uTNM staging is more effective in prognosis for RT and CRT and, therefore, should be recommended for preliminary management of epidermoid anal carcinoma.
  • [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. Chemotherapy, Adjuvant. Female. Fluorouracil / administration & dosage. Humans. Logistic Models. Male. Middle Aged. Mitomycin / administration & dosage. Neoplasm Invasiveness. Neoplasm Staging. Predictive Value of Tests. Prognosis. Prospective Studies. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 15755059.001).
  • [ISSN] 0507-3758
  • [Journal-full-title] Voprosy onkologii
  • [ISO-abbreviation] Vopr Onkol
  • [Language] rus
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Russia
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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39. 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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40. 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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41. 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


42. Moore DH: Chemotherapy and radiation therapy in the treatment of squamous cell carcinoma of the vulva: Are two therapies better than one? Gynecol Oncol; 2009 Jun;113(3):379-83
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  • [Title] Chemotherapy and radiation therapy in the treatment of squamous cell carcinoma of the vulva: Are two therapies better than one?
  • As gynecologic surgeons garnered a better understanding of various clinical-pathological prognostic factors, there evolved a number of modifications in the surgical approach allowing for more individualized therapy with less morbidity, while still retaining the curative potential of the radical vulvectomy operation.
  • The incorporation of radiation therapy and eventually chemotherapy in the primary treatment of vulva cancer also represents a slow evolution in clinical management.
  • The addition of chemotherapy concurrent to radiation therapy for the treatment of vulvar carcinoma was heavily influenced by advances in the treatment of cervical cancer, and squamous cell carcinoma of the anal canal.
  • On the basis of many good phase II studies but no randomized controlled trials in the disease, chemoradiation therapy is now inherent to the clinical management of vulvar carcinoma.
  • The rarity of vulva cancer precludes prospective randomized clinical trials in the absence of international collaboration.
  • Nonetheless, patients with locally advanced vulva cancer have derived considerable benefit from chemoradiation studies in other related tumor sites, and will continue to do so in the future.
  • [MeSH-major] Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / radiotherapy
  • [MeSH-minor] Combined Modality Therapy. Female. Humans

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  • (PMID = 19232700.001).
  • [ISSN] 1095-6859
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 77
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43. Ryan DP, Compton CC, Mayer RJ: Carcinoma of the anal canal. N Engl J Med; 2000 Mar 16;342(11):792-800
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  • [Title] Carcinoma of the anal canal.
  • Despite the rarity of carcinoma of the anal canal, remarkable progress has been achieved during the past 30 years in understanding its pathogenesis and improving treatment.
  • Largely because of the rigorous collection of data and the treatment of patients in clinical trials, it is now widely accepted that the majority of cases are caused by human papillomavirus and can be cured by combination therapy.
  • Concomitant treatment with external-beam radiation therapy and chemotherapy with fluorouracil and mitomycin represents the standard approach to combination treatment.
  • Appropriate cytologic screening of high risk populations and the integration of platinum compounds into treatment regimens will most likely reduce mortality from this disorder even further.
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Cisplatin / therapeutic use. Combined Modality Therapy. Female. HIV Infections / complications. Humans. Male. Papillomaviridae. Papillomavirus Infections / complications. Risk Factors. Sexual Behavior. Tumor Virus Infections / complications

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  • (PMID = 10717015.001).
  • [ISSN] 0028-4793
  • [Journal-full-title] The New England journal of medicine
  • [ISO-abbreviation] N. Engl. J. Med.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 125
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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. Salama JK, Mell LK, Schomas DA, Miller RC, Devisetty K, Jani AB, Mundt AJ, Roeske JC, Liauw SL, Chmura SJ: Concurrent chemotherapy and intensity-modulated radiation therapy for anal canal cancer patients: a multicenter experience. J Clin Oncol; 2007 Oct 10;25(29):4581-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Concurrent chemotherapy and intensity-modulated radiation therapy for anal canal cancer patients: a multicenter experience.
  • PURPOSE: To report a multicenter experience treating anal canal cancer patients with concurrent chemotherapy and intensity-modulated radiation therapy (IMRT).
  • PATIENTS AND METHODS: From October 2000 to June 2006, 53 patients were treated with concurrent chemotherapy and IMRT for anal squamous cell carcinoma at three tertiary-care academic medical centers.
  • All patients underwent computed tomography-based treatment planning with pelvic regions and inguinal nodes receiving a median of 45 Gy.
  • Primary sites and involved nodes were boosted to a median dose of 51.5 Gy.
  • All late toxicity was scored using Radiation Therapy Oncology Group criteria.
  • Treatment breaks occurred in 41.5% of patients, lasting a median of 4 days.
  • CONCLUSION: Preliminary outcomes suggest that concurrent chemotherapy and IMRT for anal canal cancers is effective and tolerated favorably compared with historical standards.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Radiotherapy, Intensity-Modulated / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cisplatin / administration & dosage. Combined Modality Therapy. Disease-Free Survival. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Mitomycin / administration & dosage

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  • [CommentIn] J Clin Oncol. 2008 Feb 1;26(4):688; author reply 688-9 [18235135.001]
  • [ErratumIn] J Clin Oncol. 2008 Feb 1;26(4):694
  • (PMID = 17925552.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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46. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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47. 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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48. Anal cancer incidence rates increased in antiretroviral era. Rates increased for men and women. AIDS Alert; 2006 Mar;21(3):22-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Anal cancer incidence rates increased in antiretroviral era. Rates increased for men and women.
  • Investigators compared United States surveillance data for cancer in the pre-HIV era, HIV era, and antiretroviral treatment era and found that squamous cell carcinoma of the anal canal incidence rates increased significantly in the latter era.
  • [MeSH-major] Anti-HIV Agents / therapeutic use. Anus Neoplasms / epidemiology. HIV Infections / drug therapy


49. 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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50. Kreuter A, Reimann G, Esser S, Rasokat H, Hartmann M, Swoboda J, Conant MA, Tschachler E, Arasteh K, Altmeyer P, Brockmeyer NH: [Screening and therapy of anal intraepithelial neoplasia (AIN) and anal carcinoma in patients with HIV-infection]. Dtsch Med Wochenschr; 2003 Sep 19;128(38):1957-62
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  • [Title] [Screening and therapy of anal intraepithelial neoplasia (AIN) and anal carcinoma in patients with HIV-infection].
  • [Transliterated title] Screening und Therapie der analen intraepithelialen Neoplasie (AIN) und des Analkarzinoms bei HIV-Infektion.
  • Anal intraepithelial neoplasia (AIN) is a potential precursor of invasive anal carcinoma.
  • Introduction of highly active antiretroviral therapy (HAART) in the treatment of HIV infection substantially reduced the incidence of some diseases associated with opportunistic viral infections.
  • Paradoxically, improvement of survival in the HAART era results in an increased risk of anal cancer.
  • The incidence of anal carcinoma amongst homosexual men is substantially higher compared to the normal population (35/100.000).
  • This incidence is similar to the incidence of cervical cancer before screening for CIN with cervical cytology.
  • Recent data suggest that the incidence of AIN and anal cancer is even higher among HIV-infected individuals.
  • Both cancer entities share biologic similarities, including the association with human papillomavirus infection (HPV).
  • Screening for CIN with cervical cytology and early treatment has resulted in a significant decline in the incidence of cervical carcinoma.
  • Like cervical cancer, anal carcinoma may be preventable through identification and treatment of its precursors.
  • Future efforts should focus on a screening protocol, training of clinicians in the diagnosis and treatment of AIN and anal carcinoma, and novel approaches to treatment of these lesions.
  • This screening protocol could help to reduce anal cancer in HIV-infection as well as save limited resources in health care system.
  • [MeSH-major] Anus Neoplasms / diagnosis. Carcinoma in Situ / diagnosis. HIV Infections / complications. HIV Infections / drug therapy
  • [MeSH-minor] Antiretroviral Therapy, Highly Active. Female. Humans. Male. Mass Screening. Risk Factors


51. 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

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  • (PMID = 16904522.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Grant] United States / NIMHD NIH HHS / MD / 5P60-MD000525
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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52. Deo SV, Shukla NK, Raina V, Mohanti BK, Sharan R, Kar M, Rath GK: Organ-preserving multimodality management of squamous cell carcinoma of anal canal. Indian J Gastroenterol; 2005 Sep-Oct;24(5):201-4
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  • [Title] Organ-preserving multimodality management of squamous cell carcinoma of anal canal.
  • AIM: To study the efficacy of an organ-preserving, sequential chemoradiation therapy for squamous cell carcinoma of the anal canal, and of salvage surgery in those in whom this treatment fails.
  • METHODS: Forty biopsy-proven untreated patients (28 men) with squamous cell carcinoma of the anal canal received two cycles of chemotherapy using cisplatin and methotrexate, followed by 45 to 60 (median 50) Gy external beam radiotherapy.
  • Salvage surgery was offered to those in whom this treatment failed.
  • Only three patients (7.5%) developed chemotherapy-related grade 3 mucositis and myelosuppression.
  • Three patients had post-treatment anal stenosis requiring repeated dilatation and two had chronic non-healing ulcers at the anal verge.
  • CONCLUSION: Chemoradiation is effective in the treatment of squamous cell anal cancer and has acceptable toxicity.
  • Surgical salvage may be useful in those with failure of this treatment.
  • [MeSH-major] Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy
  • [MeSH-minor] Adult. Aged. Anal Canal. Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / therapeutic use. Colostomy. Combined Modality Therapy. Female. Humans. Methotrexate / therapeutic use. Middle Aged. Salvage Therapy

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  • (PMID = 16361764.001).
  • [ISSN] 0254-8860
  • [Journal-full-title] Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology
  • [ISO-abbreviation] Indian J Gastroenterol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin; YL5FZ2Y5U1 / Methotrexate
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53. 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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  • (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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54. 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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55. 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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56. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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57. Kocáková I, Kocák I, Vyzula R, Perková H: [Concomitant preoperative chemoradiotherapy in the treatment of anal carcinoma]. Cas Lek Cesk; 2003;142 Suppl 1:36-9
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  • [Title] [Concomitant preoperative chemoradiotherapy in the treatment of anal carcinoma].
  • Carcinoma of the anal canal represents about 1-2% of digestive system cancers.
  • Its prognosis depends directly upon the size of the primary tumor and on the probability of lymphatic spread of the cancer.
  • In the past, patients with invasive anal carcinoma were routinely treated with abdominal perineal resection.
  • The NCCN institutions recommend that patients who have a carcinoma in situ can be cured with local excision with adequate margins.
  • Patients who have a T1 lesion receive external beam radiotherapy (50-59 Gy) plus or minus mitomycin/5-fluorouracil.
  • Patients with T2-T4 lesion, especially if inguinal nodes are positive, should receive the combination of mitomycin/5-fluorouracil plus radiotherapy (50-59 Gy) to include the inguinal and pelvic lymph node regions.
  • Patients receiving the combination therapy (chemotherapy with radiation therapy) when compared with those with radiation therapy alone have a significantly better local control (60% versus 39%).
  • Patients whose tumor was not eradicated are candidates for additional chemotherapy with 5-fluorouracil/cisplatin.
  • [MeSH-major] Anus Neoplasms / therapy. Carcinoma / therapy
  • [MeSH-minor] Combined Modality Therapy. Humans

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  • (PMID = 12924049.001).
  • [ISSN] 0008-7335
  • [Journal-full-title] Casopís lékar̆ů c̆eských
  • [ISO-abbreviation] Cas. Lek. Cesk.
  • [Language] cze
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Czech Republic
  • [Number-of-references] 33
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58. 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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59. 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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60. Jephcott CR, Paltiel C, Hay J: Quality of life after non-surgical treatment of anal carcinoma: a case control study of long-term survivors. Clin Oncol (R Coll Radiol); 2004 Dec;16(8):530-5
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  • [Title] Quality of life after non-surgical treatment of anal carcinoma: a case control study of long-term survivors.
  • AIMS: To evaluate the quality of life (QOL) of a cohort of patients after non-surgical treatment of anal carcinoma with chemotherapy and radiation.
  • MATERIALS AND METHODS: Patients treated for anal carcinoma at the British Columbia Cancer Agency between 1990 and 2001 were identified from audit data.
  • The European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and EORTC QLQ-CR38 instruments were used to evaluate general QOL, and more disease and site-related aspects.
  • Fifty responses were received and were compared with those of a sample of matched local volunteer control participants who had not received any treatment to their abdomen or pelvis.
  • Identified general areas involved physical, social, and role functions, and symptoms of fatigue, nausea and vomiting, dyspnoea, appetite loss, diarrhoea, constipation, and financial problems, with cancer/site-related micturition, gastrointestinal and chemotherapy side-effect symptoms, and male and female sexual problems.
  • CONCLUSION: This study reveals that after curative treatment for anal carcinoma with chemoradiation that has spared the patient of surgery, issues affecting QOL can present in a significant proportion of patients.
  • [MeSH-major] Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma / drug therapy. Carcinoma / radiotherapy. Quality of Life. Survivors

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  • (PMID = 15630846.001).
  • [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] Journal Article
  • [Publication-country] England
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61. 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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62. 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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63. Chao C, Goldberg M, Hoffman JP: Surgical salvage therapy: abdominoperineal resection for recurrent anal carcinoma, metastasectomy of recurrent colorectal cancer, and esophagectomy after combined chemoradiation. Curr Opin Oncol; 2000 Jul;12(4):353-6
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  • [Title] Surgical salvage therapy: abdominoperineal resection for recurrent anal carcinoma, metastasectomy of recurrent colorectal cancer, and esophagectomy after combined chemoradiation.
  • This review highlights the advances in the salvage surgical therapies for recurrent disease after definitive therapy of anal carcinoma, colorectal cancer, including liver metastasectomy, and esophageal carcinoma treated primarily with chemoradiation.
  • New diagnostic modalities, advances in neoadjuvant therapies for unresectable liver metastases, and, in addition, the importance of adjuvant hepatic arterial chemotherapy after curative liver resections are reviewed.
  • Although chemoradiation is not the standard of care for esophageal cancer, salvage esophagectomy after such treatment is discussed.
  • Definitive chemoradiation for squamous cell carcinoma of the anus has altered the role of surgical intervention to a salvage option instead of primary treatment.
  • Although this is not yet the case for esophageal carcinoma, recent improved chemoradiation regimens have been reported by the French and Japanese, who use surgery for nonresponders.
  • For recurrent colorectal carcinoma, including liver-only metastases, patients can be rendered disease free after surgical extirpation with evidence of improved survival.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy. Esophagectomy. Neoplasm Recurrence, Local / therapy. Rectal Neoplasms / therapy. Salvage Therapy
  • [MeSH-minor] Abdomen / surgery. Chemotherapy, Adjuvant. Colorectal Neoplasms / pathology. Colorectal Neoplasms / therapy. Humans. Liver Neoplasms / pathology. Liver Neoplasms / therapy. Perineum / surgery. Radiotherapy, Adjuvant

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  • (PMID = 10888421.001).
  • [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] 26
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64. Gorez E, Staumont G: [Epidermoid anal carcinoma]. Rev Prat; 2008 Oct 31;58(16):1783-92
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  • [Title] [Epidermoid anal carcinoma].
  • [Transliterated title] Carcinome epidermoïde anal.
  • Epidermoid carcinoma of the anus is a rare cancer, and conventionally affects elderly women.
  • Main predisposing factors are sexually transmitted diseases and particularly human papillomavirus (HPV) infection, variety of sexual partners, smoking, homosexuality, history of uterine cervix cancer, and immunodepression.
  • Warning signs of anal cancer are often non-specific.
  • The evaluation assessment should include lung X-ray, abdominal CT scan, and often pelvis MNR or anal endosonography.
  • First-line treament of anal epidermoid carcinoma is radiotherapy, combined with chemotherapy for extensive forms.
  • [MeSH-major] Anus Neoplasms. Carcinoma, Squamous Cell
  • [MeSH-minor] Age Factors. Aged. Anal Canal / pathology. Biopsy. Combined Modality Therapy. Female. Homosexuality, Male. Humans. Lymphatic Metastasis. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Staging. Prognosis. Radiotherapy Dosage. Risk Factors. Sex Factors

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  • (PMID = 19143150.001).
  • [ISSN] 0035-2640
  • [Journal-full-title] La Revue du praticien
  • [ISO-abbreviation] Rev Prat
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] France
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65. 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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66. Hung A, Crane C, Delclos M, Ballo M, Ajani J, Lin E, Feig B, Skibber J, Janjan N: Cisplatin-based combined modality therapy for anal carcinoma: a wider therapeutic index. Cancer; 2003 Mar 1;97(5):1195-202
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  • [Title] Cisplatin-based combined modality therapy for anal carcinoma: a wider therapeutic index.
  • BACKGROUND: Definitive chemoradiation therapy is the standard of care for anal carcinoma.
  • The chemotherapy regimen comprising 5-fluorouracil (5-FU) and mitomycin-C is the most commonly used among patients with anal carcinoma but causes well documented toxicities.
  • In the current study, the authors evaluated their experience in treating anal carcinoma with combined modality therapy using cisplatin and 5-FU.
  • METHODS: A retrospective analysis was performed of 92 patients with nonmetastatic squamous cell carcinoma of the anus who were treated between 1989 and 1998.
  • The primary tumor and involved lymph nodes received a total dose of 55 grays (Gy) administered in more than 30 daily fractions.
  • Greater than 90% of patients completed treatment without significant treatment interruption.
  • Only five patients developed acute toxicities of Radiation Therapy Oncology Group (RTOG) Grade 4 or higher and only three patients developed chronic toxicities of RTOG Grade 4 or higher.
  • CONCLUSIONS: Combined modality therapy with continuous infusion of cisplatin and 5-FU is a well tolerated regimen that results in high rates of LC, OS, and sphincter preservation.
  • Without the normally severe toxicity, cisplatin-based therapy results in a wider therapeutic index.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Carcinoma, Squamous Cell / drug therapy. Cisplatin / therapeutic use
  • [MeSH-minor] Combined Modality Therapy. Disease-Free Survival. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Pilot Projects. Retrospective Studies. Survival Rate. Treatment Outcome

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  • [Copyright] Copyright 2003 American Cancer Society.
  • (PMID = 12599225.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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67. 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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68. 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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69. 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

  • [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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70. 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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71. Fallai C, Cerrotta A, Valvo F, Badii D, Olmi P: Anal carcinoma of the elderly treated with radiotherapy alone or with concomitant radio-chemotherapy. Crit Rev Oncol Hematol; 2007 Mar;61(3):261-8
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  • [Title] Anal carcinoma of the elderly treated with radiotherapy alone or with concomitant radio-chemotherapy.
  • PURPOSE: To analyse the results achieved with radio-chemotherapy (RTCT) or radiotherapy alone (RT) in elderly patients (pts) affected with squamous cell anal cancer.
  • No G3 acute toxicity was observed in the RT group; in the RTCT group 15 pts (31%) developed a G3+ acute toxicity.
  • [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. Chemotherapy, Adjuvant / adverse effects. Combined Modality Therapy / adverse effects. Dose Fractionation. Female. Follow-Up Studies. Frail Elderly. Humans. Male. Neoplasm Staging. Survival Analysis. Treatment Outcome

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  • (PMID = 17085056.001).
  • [ISSN] 1040-8428
  • [Journal-full-title] Critical reviews in oncology/hematology
  • [ISO-abbreviation] Crit. Rev. Oncol. Hematol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
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72. 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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73. 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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74. Hauerstock D, Ennis RD, Grossbard M, Evans A: Efficacy and toxicity of chemoradiation in the treatment of HIV-associated anal cancer. Clin Colorectal Cancer; 2010 Oct;9(4):238-42
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  • [Title] Efficacy and toxicity of chemoradiation in the treatment of HIV-associated anal cancer.
  • PURPOSE: The purpose of this retrospective study is to determine the results and the toxicity of concurrent chemoradiation for squamous cell carcinoma of the anal canal in HIV-positive patients treated at a single institution.
  • PATIENTS AND METHODS: HIV-positive patients with squamous cell carcinoma of the canal treated at Continuum Cancer Centers-affiliated hospitals were identified from tumor registries.
  • We reviewed hospital and treatment charts to gather data relating to demographics, HIV status including cluster of differentiation 4 (CD4) count and viral load, tumor stage, radiation and chemotherapy treatment, toxicity and local control, and survival.
  • All patients received radiation and concurrent chemotherapy consisting of either mitomycin-C and 5-fluorouracil (5-FU; 20 patients), cisplatin and 5-FU (13 patients), or 5-FU alone (1 patient).
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy. HIV Infections / complications. Radiotherapy, Conformal
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Radiotherapy, Intensity-Modulated. Retrospective Studies. Survival Analysis. Treatment Outcome


75. 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

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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76. Alfaro-Rubio A, Nagore E, Serra C, Botella R, Sanmartín O, Requena C, Llombart B, Hueso L, Guillén C: [Perianal Bowen's disease treated with imiquimod]. Actas Dermosifiliogr; 2005 Sep;96(7):468-70
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  • [Title] [Perianal Bowen's disease treated with imiquimod].
  • [Transliterated title] Enfermedad de Bowen perianal tratada con imiquimod.
  • Bowen's disease is a special form of squamous cell carcinoma in situ that usually develops in photoexposed areas of skin.
  • The treatment of choice is surgery.
  • Less frequently, it may appear in other locations such as the nails, glans penis, intertriginous areas and the perianal region, where conventional treatment may be complicated.
  • We contribute a new case of perianal Bowen's disease, which responded to treatment with imiquimod with no evidence of clinical recurrence after 3 years of follow up.
  • Imiquimod appears to be a therapeutic alternative for perianal Bowen's disease, which seems to have a particular tendency to recur in this location where surgery may also be complicated.
  • [MeSH-major] Aminoquinolines / therapeutic use. Antineoplastic Agents / therapeutic use. Anus Neoplasms / drug therapy. Bowen's Disease / drug therapy. Skin Neoplasms / drug therapy

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  • (PMID = 16476278.001).
  • [ISSN] 0001-7310
  • [Journal-full-title] Actas dermo-sifiliográficas
  • [ISO-abbreviation] Actas Dermosifiliogr
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Spain
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Antineoplastic Agents; 99011-02-6 / imiquimod
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77. 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

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  • (PMID = 19744801.001).
  • [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] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anti-HIV Agents; 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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78. 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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  • [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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79. 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


80. 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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81. Rasheed S, Yap T, Zia A, McDonald PJ, Glynne-Jones R: Chemo-radiotherapy: an alternative to surgery for squamous cell carcinoma of the rectum--report of six patients and literature review. Colorectal Dis; 2009 Feb;11(2):191-7
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  • [Title] Chemo-radiotherapy: an alternative to surgery for squamous cell carcinoma of the rectum--report of six patients and literature review.
  • PURPOSE: Since 1943 [1], only 45 patients of squamous cancer of the rectum have been reported in the published reports and the largest series to date consists of 12 patients.
  • Reports suggest that the primary treatment is surgical resection but, in the light of nonsurgical advances in the treatment of anal squamous cell carcinoma (SCC), we present a review of the literature and report six patients treated by chemoradiation therapy (CRT).
  • METHOD: A literature search was undertaken using the keywords squamous cell, epidermoid, basaloid and cloacagenic and cancer of rectum and colon to provide evidence for this discussion from studies of surgery, radiation therapy and CRT in rectal SCC.
  • A prospective database of the Mount Vernon Cancer Centre, UK was searched from 1995 to 2005 for patients diagnosed with pure SCC of the rectum.
  • RESULTS: Six patients with histologically confirmed primary SCC of the rectum were treated with primary combination chemo-radiotherapy according to protocols used for SCC of the anal canal over a 15-year period.
  • CONCLUSIONS: Primary CRT, as currently utilized in anal cancer, can be extended to primary SCC of the rectum.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Rectal Neoplasms / drug therapy. Rectal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Cohort Studies. Combined Modality Therapy. Disease-Free Survival. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Radiotherapy / methods

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  • (PMID = 18462236.001).
  • [ISSN] 1463-1318
  • [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; Review
  • [Publication-country] England
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Number-of-references] 40
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82. Czito BG, Willett CG: Current management of anal canal cancer. Curr Oncol Rep; 2009 May;11(3):186-92
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  • [Title] Current management of anal canal cancer.
  • Squamous cell carcinoma of the anal canal historically has been treated with abdominoperineal resection, resulting in high rates of morbidity and local recurrence.
  • Pioneering work led to the finding that radiation therapy (RT) combined with 5-fluorouracil (5-FU) and mitomycin results in high rates of local control and disease-free and colostomy-free survival without surgery.
  • At present, RT with 5-FU and mitomycin is the standard of care for anal cancer patients.
  • Recent advances include the integration of positron emission tomography into staging, radiation treatment planning and monitoring, and the use of intensity modulated RT.
  • [MeSH-major] Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Fluorouracil / administration & dosage. Humans. Mitomycin / administration & dosage. Randomized Controlled Trials as Topic. Survival Analysis

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  • (PMID = 19336010.001).
  • [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] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
  • [Number-of-references] 24
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83. 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
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ PMC2361984
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84. Klenova A, Balabanova A: [Conservative treatment of the spinocellular cancer of the anal canal--a brief survey and report on 6 cases]. Khirurgiia (Sofiia); 2008;(3):25-31
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  • [Title] [Conservative treatment of the spinocellular cancer of the anal canal--a brief survey and report on 6 cases].
  • PURPOSE: The conservative treatment for carcinoma of the anal canal has become the standard care for this malignancy.
  • MATERIAL AND METHODS: Between February and December 2003 six female patients with UICC T2-3, No, Mo, G1-G2 squamous-cell carcinoma of the anal canal were treated.
  • The curative scheme included definitive irradiation by external beam radiation therapy and concomitant chemotherapy with Cisplatinum.
  • The total tumor dose of 50.4 Gy, 1.8 Gy/day, 5 fractions weekly, was delivered to the pelvis and the primary tumor; for the inguinal lymph nodes the total dose was 41.4 Gy, 1.8 Gy/day, 5 fractions weekly.
  • After interruption of 14 days, a local boost irradiation to the primary tumor was given--16 Gy, 2 Gy/day, 5 fractions weekly.
  • The therapy was well tolerated, with good anal continence and moderate late side effects, including soft chronic diarrhea.
  • [MeSH-major] Anal Canal / pathology. Antineoplastic Agents / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Cisplatin / therapeutic use. Intestinal Neoplasms / drug therapy. Intestinal Neoplasms / radiography
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Female. Humans. Radiotherapy Dosage

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  • (PMID = 20063470.001).
  • [ISSN] 0450-2167
  • [Journal-full-title] Khirurgii︠a︡
  • [ISO-abbreviation] Khirurgiia (Sofiia)
  • [Language] bul
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Bulgaria
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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85. Matzinger O, Roelofsen F, Mineur L, Koswig S, Van Der Steen-Banasik EM, Van Houtte P, Haustermans K, Radosevic-Jelic L, Mueller RP, Maingon P, Collette L, Bosset JF, EORTC Radiation Oncology and Gastrointestinal Tract Cancer Groups: Mitomycin C with continuous fluorouracil or with cisplatin in combination with radiotherapy for locally advanced anal cancer (European Organisation for Research and Treatment of Cancer phase II study 22011-40014). Eur J Cancer; 2009 Nov;45(16):2782-91
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  • [Title] Mitomycin C with continuous fluorouracil or with cisplatin in combination with radiotherapy for locally advanced anal cancer (European Organisation for Research and Treatment of Cancer phase II study 22011-40014).
  • PURPOSE: To assess the feasibility and activity of radio-chemotherapy with mitomycin C (MMC) and cisplatin (CDDP) in locally advanced squamous cell anal carcinoma with reference to radiotherapy (RT) combined with MMC and fluorouracil (5-FU).
  • Forty patients/arm were needed to exclude a RECIST objective response rate (ORR), 8 weeks after treatment, of <75% (Fleming 1, alpha=10%, beta=10%).
  • In the MMC/5-FU group, two patients (5.1%) discontinued treatment due to toxicity versus 11 (29.7%) in the MMC/CDDP group.
  • Thirty-one patients in the MMC/5-FU arm (79.5%) and 18 in the MMC/CDDP arm (48.6%) were fully compliant with the protocol treatment (p=0.005).
  • CONCLUSIONS: Radio-chemotherapy with MMC/CDDP seems promising as only MMC/CDDP demonstrated enough activity (RECIST ORR >75%) to be tested further in phase III trials; MMC/5-FU did not.
  • [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. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy. Disease-Free Survival. Feasibility Studies. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Mitomycin / adverse effects. Patient Compliance. Treatment Outcome

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  • (PMID = 19643599.001).
  • [ISSN] 1879-0852
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Databank-accession-numbers] ClinicalTrials.gov/ NCT00068744
  • [Grant] United States / NCI NIH HHS / CA / 2U10 CA11488-31
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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86. 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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87. 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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88. Serkies K, Bednaruk-Mlynski E, Dziadziuszko R, Jassem J: Conservative treatment for carcinoma of the anus--a report of 35 patients. Neoplasma; 2003;50(2):152-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Conservative treatment for carcinoma of the anus--a report of 35 patients.
  • Conservative treatment for carcinoma of the anus has become the standard care for this malignancy.
  • In this study we report on our experience with this method with particular emphasis on treatment outcome and acute toxicity.
  • Between April 1991 and February 2002, 35 patients (male/female ratio 0.35) with UICC T(1-i) N(0-3) M(0) squamous cell carcinoma of the anal canal or anal margin were treated with chemo-radiation (31 patients) or radiotherapy alone (4 patients).
  • The total tumor dose of 48 to 60 Gy was delivered either by split-course or continuous radiation therapy to the pelvis, followed by a local boost to the primary tumor.
  • Chemotherapy included one or two cycles of mitomycin C (10-15 mg/m(2) day 1) and 5-fluorouracil (450-750 mg/m(2) day 1 to 4 or 5) given during the first and the last part of irradiation.
  • Overall, local treatment failure was observed in twelve patients (35%) including eight with T3 and one with T4 tumor.
  • Moderate anal stool incontinence occurred in three patients (9%).
  • In conclusion, conservative management of anal carcinoma allows durable colostomy-free survival in a proportion of patients.
  • [MeSH-major] Anus Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Colostomy. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Retrospective Studies

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  • (PMID = 12740652.001).
  • [ISSN] 0028-2685
  • [Journal-full-title] Neoplasma
  • [ISO-abbreviation] Neoplasma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Slovakia
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89. 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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90. 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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  • [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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91. 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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92. Hill J, Meadows H, Haboubi N, Talbot IC, Northover JM: Pathological staging of epidermoid anal carcinoma for the new era. Colorectal Dis; 2003 May;5(3):206-13
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  • [Title] Pathological staging of epidermoid anal carcinoma for the new era.
  • Chemoradiotherapy is the standard treatment for most patients with epidermoid anal cancer.
  • Pre-treatment staging is based on size for T1-T3 lesions and clinical and radiological assessment of adjacent organ invasion for T4 lesions.
  • For patients with residual or recurrent carcinoma, anorectal excision offers the best chance of oncological salvage.
  • Pathological staging systems for anorectal excision specimens were validated at the time when surgical treatment was first line therapy.
  • A validated staging system is necessary for salvage surgical excision specimens following an attempt to cure by radiotherapy and chemotherapy for the purpose of prognosis and further treatment planning.
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma, Squamous Cell / pathology. Neoplasm Staging / standards

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  • (PMID = 12780879.001).
  • [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; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Number-of-references] 51
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93. 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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94. 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


95. Oehler C, Provencher S, Donath D, Bahary JP, Lütolf UM, Ciernik IF: Chemo-radiation with or without mandatory split in anal carcinoma: experiences of two institutions and review of the literature. Radiat Oncol; 2010;5:36
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  • [Title] Chemo-radiation with or without mandatory split in anal carcinoma: experiences of two institutions and review of the literature.
  • BACKGROUND: The split-course schedule of chemo-radiation for anal cancer is controversial.
  • METHODS: Eighty-four patients with invasive anal cancer treated with definitive external beam radiotherapy (RT) with a mandatory split of 12 days (52 patients, Montreal, Canada) or without an intended split (32 patients, Zurich, Switzerland) were reviewed.
  • Total RT doses were 52 Gy (Montreal) or 59.4 Gy (Zurich) given concurrently with 5-FU/MMC.
  • Patients from Zurich with prolonged treatment interruption (> or = 7 d) had impaired cancer-specific survival compared with patients with only minor interruption (<7 d) (P = 0.06).
  • Skin toxicity correlated with institution and was found in 79% (Montreal) and 28% (Zurich) (P < 0.0001).
  • CONCLUSIONS: The study design did not allow demonstrating a clear difference in efficacy between the treatment regimens with or without short mandatory split.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Radiotherapy, Conformal
  • [MeSH-minor] Cisplatin / administration & dosage. Combined Modality Therapy. Dose-Response Relationship, Radiation. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Retrospective Studies. Review Literature as Topic. Survival Rate. Time Factors. Treatment Outcome

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  • (PMID = 20465811.001).
  • [ISSN] 1748-717X
  • [Journal-full-title] Radiation oncology (London, England)
  • [ISO-abbreviation] Radiat Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ PMC2879246
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96. Horster S, Thoma-Greber E, Siebeck M, Bogner JR: Is anal carcinoma a HAART-related problem? Eur J Med Res; 2003 Apr 30;8(4):142-6
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  • [Title] Is anal carcinoma a HAART-related problem?
  • METHOD: 1472 patients were screened 3655 times for ACA as a strong risk factor for AIN/AC.
  • Time between HIV-infection and AC as well as time between ACA and AC is assessed, pre-treatment with HAART, age, CD4-cell count and CDC-stage at timepoint of diagnosis of AC is mentioned.
  • AIN/AC occurs more often in HIV+ individuals, preferably in advanced disease stages, at younger age and within a shorter time after first signs of ACA than in HIV-negative population.
  • [MeSH-major] Antiretroviral Therapy, Highly Active / adverse effects. Anus Neoplasms / etiology. HIV Infections / complications. HIV Infections / drug therapy
  • [MeSH-minor] Adult. Anus Diseases / complications. Carcinoma in Situ / etiology. Condylomata Acuminata / complications. Female. Humans. Male. Risk Factors


97. Runfola MA, Weber TK, Rodriguez-Bigas MA, Dougherty TJ, Petrelli NJ: Photodynamic therapy for residual neoplasms of the perianal skin. Dis Colon Rectum; 2000 Apr;43(4):499-502
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  • [Title] Photodynamic therapy for residual neoplasms of the perianal skin.
  • PURPOSE: The aim of this study was to evaluate the efficacy of photodynamic therapy in the management of residual neoplasms of the perianal skin.
  • Five patients with pathologic confirmation of residual perianal neoplasms were treated with photodynamic therapy.
  • Pathology consisted of Bowen's disease in two patients, squamous-cell carcinoma in two patients, and extramammary Paget's disease in one patient.
  • Four patients received one photodynamic therapy treatment and one patient received two treatments three months apart.
  • RESULTS: Treatment was followed by immediate perianal erythema, subsequent blister formation in 36 to 48 hours, and sloughing of the treated area in 72 hours.
  • One recurrence was in a patient four years after treatment for Paget's disease, and the other was in a patient nine months after treatment for Bowen's disease.
  • Treatment-related toxicities included significant perianal pain in four patients, controlled with analgesia management.
  • CONCLUSIONS: Photodynamic therapy can successfully be used after wide local excision for residual neoplasms of the perianal skin.
  • Treatment can be rendered with acceptable morbidity.
  • [MeSH-major] Anal Canal / pathology. Anus Neoplasms / drug therapy. Bowen's Disease / drug therapy. Carcinoma, Squamous Cell / drug therapy. Paget Disease, Extramammary / drug therapy. Photochemotherapy. Skin Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Female. Humans. Male. Middle Aged. Neoplasm, Residual. Treatment Outcome

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  • (PMID = 10789745.001).
  • [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
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98. 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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99. Ajani JA, Winter KA, Gunderson LL, Pedersen J, Benson AB 3rd, Thomas CR Jr, Mayer RJ, Haddock MG, Rich TA, Willett C: Fluorouracil, mitomycin, and radiotherapy vs fluorouracil, cisplatin, and radiotherapy for carcinoma of the anal canal: a randomized controlled trial. JAMA; 2008 Apr 23;299(16):1914-21
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  • [Title] Fluorouracil, mitomycin, and radiotherapy vs fluorouracil, cisplatin, and radiotherapy for carcinoma of the anal canal: a randomized controlled trial.
  • CONTEXT: Chemoradiation as definitive therapy is the preferred primary therapy for patients with anal canal carcinoma; however, the 5-year disease-free survival rate from concurrent fluorouracil/mitomycin and radiation is only approximately 65%.
  • OBJECTIVE: To compare the efficacy of cisplatin-based (experimental) therapy vs mitomycin-based (standard) therapy in treatment of anal canal carcinoma.
  • DESIGN, SETTING, AND PARTICIPANTS: US Gastrointestinal Intergroup trial RTOG 98-11, a multicenter, phase 3, randomized controlled trial comparing treatment with fluorouracil plus mitomycin and radiotherapy vs treatment with fluorouracil plus cisplatin and radiotherapy in 682 patients with anal canal carcinoma enrolled between October 31, 1998, and June 27, 2005.
  • (1) the mitomycin-based group (n = 341), who received fluorouracil (1000 mg/m2 on days 1-4 and 29-32) plus mitomycin (10 mg/m2 on days 1 and 29) and radiotherapy (45-59 Gy) or (2) the cisplatin-based group (n = 341), who received fluorouracil (1000 mg/m2 on days 1-4, 29-32, 57-60, and 85-88) plus cisplatin (75 mg/m2 on days 1, 29, 57, and 85) and radiotherapy (45-59 Gy; start day = day 57).
  • MAIN OUTCOME MEASURES: The primary end point was 5-year disease-free survival; secondary end points were overall survival and time to relapse.
  • The 5-year local-regional recurrence and distant metastasis rates were 25% (95% CI, 20%-30%) and 15% (95% CI, 10%-20%), respectively, for mitomycin-based treatment and 33% (95% CI, 27%-40%) and 19% (95% CI, 14%-24%), respectively, for cisplatin-based treatment.
  • The cumulative rate of colostomy was significantly better for mitomycin-based than cisplatin-based treatment (10% vs 19%; P = .02).
  • Severe hematologic toxicity was worse with mitomycin-based treatment (P < .001).
  • CONCLUSIONS: In this population of patients with anal canal carcinoma, cisplatin-based therapy failed to improve disease-free-survival compared with mitomycin-based therapy, but cisplatin-based therapy resulted in a significantly worse colostomy rate.
  • These findings do not support the use of cisplatin in place of mitomycin in combination with fluorouracil and radiotherapy in the treatment of anal canal carcinoma.

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  • [CommentIn] Nat Clin Pract Gastroenterol Hepatol. 2009 Jan;6(1):16-7 [19047998.001]
  • [CommentIn] JAMA. 2008 Sep 24;300(12):1410-1; author reply 1411 [18812528.001]
  • (PMID = 18430910.001).
  • [ISSN] 1538-3598
  • [Journal-full-title] JAMA
  • [ISO-abbreviation] JAMA
  • [Language] ENG
  • [Databank-accession-numbers] ClinicalTrials.gov/ NCT00003596
  • [Grant] United States / NCI NIH HHS / CA / U10 CA21661; United States / NCI NIH HHS / CA / U10 CA32115; United States / NCI NIH HHS / CA / U10 CA37422
  • [Publication-type] Clinical Trial, Phase III; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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100. 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
Hazardous Substances Data Bank. FLUOROURACIL .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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

  • Genetic Alliance. consumer health - HIV.
  • MedlinePlus Health Information. consumer health - Anal Cancer.
  • MedlinePlus Health Information. consumer health - HIV/AIDS.
  • Hazardous Substances Data Bank. CIS-DIAMINEDICHLOROPLATINUM .
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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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