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1. Chauveinc L, Buthaud X, Falcou MC, Mosseri V, De la Rochefordière A, Pierga JY, Girodet J, Salmon RJ: Anal canal cancer treatment: practical limitations of routine prescription of concurrent chemotherapy and radiotherapy. Br J Cancer; 2003 Dec 1;89(11):2057-61
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  • [Title] Anal canal cancer treatment: practical limitations of routine prescription of concurrent chemotherapy and radiotherapy.
  • This study is an analysis of the criteria considered when prescribing concomitant chemotherapy and radiotherapy, as a routine treatment for patients with anal canal cancer, and related complications.
  • Between 1990 and 1996, 67 patients were treated at Institut Curie for invasive, nonmetastatic cancer of the anal canal.
  • TNM stage distribution was as follows: seven T1, 17 T2, 27 T3, 16 T4, and 22 N+ patients.
  • A total of 29 patients (i.e., five T1/T2, and 24 T3/T4) received concurrent chemotherapy and radiotherapy.
  • Radiotherapy volumes and dose and prescribed dose for chemotherapy were not statistically different from one group of patients to another.
  • Only 55% of T3/T4 patients underwent standard chemoradiation treatment for anal canal cancer.
  • Age was the one of main factor in determining if the patient would undergo concomitant chemotherapy or not.
  • For the T3/T4 patients, concomitant chemotherapy was prescribed to 69% of patients <55 years, 90% of patients between 56 and 64 years, 45% of patients between 65 and 75 years, and 20% of patients over 75 years (P<0.02).
  • The 4 years overall survival rate of T3/T4 patients, who underwent concomitant chemotherapy, was 72%, and that of T3/T4 patient who did not, was 34% (P<0.04).
  • The patients who did not undergo chemotherapy were significantly older.
  • Relapse-free interval of T3/T4 patients was 78% with chemotherapy and 60% without chemotherapy (p=NS).
  • Rates of treatment discontinuation and early toxicity were not statistically different.
  • At 2 years, complications occurred in 39% of patients who had undergone concomitant chemotherapy, and in 20% of patients who had not (p<0.02).
  • In conclusion, although radiotherapy with concomitant chemotherapy is considered the current 'gold-standard' treatment for anal canal cancer, in our daily experience, only 55% of our T3/T4 patients have undergone this treatment.
  • The remainder did not undergo chemotherapy mainly because they were deemed too old.
  • In this series, no increase in local control and cause-specific survival was observed in patients who received concomitant chemotherapy; this may be due to the small number of patients included in the series.
  • The increased rate of late complications observed in patients who received the combined treatment, however, provides evidence that this treatment should be restricted to younger patients without comorbidity and therefore justifies our position.
  • Perhaps reduction of doses of chemotherapy must be discussed for older patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma / drug therapy. Carcinoma / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cisplatin / administration & dosage. Combined Modality Therapy. Fluorouracil / administration & dosage. Humans. Iridium Radioisotopes. Lymphatic Metastasis. Male. Middle Aged. Radiotherapy Dosage. Survival Rate

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  • (PMID = 14647138.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Iridium Radioisotopes; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ PMC2376848
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2. Oehler-Jänne C, Seifert B, Lütolf UM, Ciernik IF: Local tumor control and toxicity in HIV-associated anal carcinoma treated with radiotherapy in the era of antiretroviral therapy. Radiat Oncol; 2006;1:29
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  • [Title] Local tumor control and toxicity in HIV-associated anal carcinoma treated with radiotherapy in the era of antiretroviral therapy.
  • PURPOSE: To investigate the outcome of HIV-seropositive patients under highly active antiretroviral treatment (HAART) with anal cancer treated with radiotherapy (RT) alone or in combination with standard chemotherapy (CT).
  • PATIENTS AND METHODS: Clinical outcome of 81 HIV-seronegative patients (1988-2003) and 10 consecutive HIV-seropositive patients under HAART (1997-2003) that were treated with 3-D conformal RT of 59.4 Gy and standard 5-fluorouracil and mitomycin-C were retrospectively analysed.
  • 10 TNM-stage and age matched HIV-seronegative patients (1992-2003) were compared with the 10 HIV-seropositive patients.
  • Pattern of care, local disease control (LC), overall survival (OS), cancer-specific survival (CSS), and toxicity were assessed.
  • No HIV-seropositive patient received an interstitial brachytherapy boost compared to 42% of all HIV-seronegative patients and adherence to chemotherapy seemed to be difficult in HIV-seropositive patients.
  • CONCLUSION: Despite high response rates to organ preserving treatment with RT with or without CT, local tumor failure seems to be high in HIV-positive patients receiving HAART.
  • HIV-seropositive patients are subject to treatment bias, being less likely treated with interstitial brachytherapy boost probably due to HIV-infection, and they are at risk to receive less chemotherapy.
  • [MeSH-major] Antiretroviral Therapy, Highly Active. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Anus Neoplasms / virology. HIV Infections / complications. HIV Infections / drug therapy. Radiotherapy / methods
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents / therapeutic use. Combined Modality Therapy / methods. Female. Fluorouracil / therapeutic use. HIV Seropositivity. Humans. Male. Middle Aged. Mitomycin / therapeutic use. Retrospective Studies. Treatment Outcome


3. Ben-Josef E, Moughan J, Ajani JA, Flam M, Gunderson L, Pollock J, Myerson R, Anne R, Rosenthal SA, Willett C: Impact of overall treatment time on survival and local control in patients with anal cancer: a pooled data analysis of Radiation Therapy Oncology Group trials 87-04 and 98-11. J Clin Oncol; 2010 Dec 1;28(34):5061-6
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  • [Title] Impact of overall treatment time on survival and local control in patients with anal cancer: a pooled data analysis of Radiation Therapy Oncology Group trials 87-04 and 98-11.
  • PURPOSE: To determine whether increased duration of radiation therapy (RT) and overall treatment (RX) time has a detrimental effect in anal cancer.
  • PATIENTS AND METHODS: Data from Radiation Therapy Oncology Group (RTOG) 87-04 and RTOG 98-11 trials were combined to form three treatment groups: RT/fluorouracil (FU)/mitomycin (n = 472), RT/FU/cisplatin (n = 320), and RT/FU (n = 145).
  • Cox proportional hazards models were used with the following variables: RT duration, RT intensity, RX duration, treatment group, age, sex, Karnofsky performance score (KPS), T stage, N stage, and RT dose.
  • RESULTS: In the univariate analysis, there was a significant association between RX duration and colostomy failure (CF; hazard ratio [HR] = 1.51; 95% CI, 1.07 to 2.14; P = .02), local failure (HR = 1.52; 95% CI, 1.14 to 2.03; P = .005), locoregional failure (HR = 1.51; 95% CI, 1.15 to 1.98; P = .003), and time to failure (HR = 1.40; 95% CI, 1.10 to 1.79; P = .007).
  • The significance of RX duration was maintained after adjusting for treatment group.
  • Age, sex, KPS, T stage, N stage, and RT dose, but not RT duration, RT intensity, or RX duration, were found to be statistically significant predictors of OS and colostomy-free survival.
  • CONCLUSION: Total treatment time, but not duration of radiation therapy, seems to have a detrimental effect on local failure and colostomy rate in anal cancer.
  • Induction chemotherapy may contribute to local failure by increasing total treatment time.

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  • (PMID = 20956625.001).
  • [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
  • [Grant] United States / NCI NIH HHS / CA / U10 CA021661; United States / NCI NIH HHS / CA / U10 CA037422; United States / NCI NIH HHS / CA / U10 CA21661; United States / NCI NIH HHS / CA / U10 CA37422
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 50SG953SK6 / Mitomycin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ PMC3018356
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4. Weber DC, Kurtz JM, Allal AS: The impact of gap duration on local control in anal canal carcinoma treated by split-course radiotherapy and concomitant chemotherapy. Int J Radiat Oncol Biol Phys; 2001 Jul 1;50(3):675-80
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  • [Title] The impact of gap duration on local control in anal canal carcinoma treated by split-course radiotherapy and concomitant chemotherapy.
  • PURPOSE: To investigate the potential benefit of reducing the intersequence gap in patients with anal cancer treated with split-course chemoradiotherapy.
  • METHODS: The study group consisted of 90 patients with anal squamous carcinoma treated between 1981 and 1998, using concomitant chemotherapy (CT) and radiation (RT).
  • First (pelvic) sequence delivered a median dose of 40 Gy (range 36-50.4), using AP/PA megavoltage photon beams.
  • Boost treatment (median dose 20 Gy, range 13-26) consisted of either Iridium-192 implantation (49 patients) or external beam RT (41 patients).
  • Number of CT cycles (1 vs. 2 or more), boost technique (brachytherapy vs. external), and T-stage were not significantly associated with LRC.
  • CONCLUSION: In anal cancers, split-course RT with > 50 Gy dose delivery is difficult to avoid because of acute toxicity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Dose Fractionation. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Multivariate Analysis. Retrospective Studies. Time Factors

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  • (PMID = 11395235.001).
  • [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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5. Deniaud-Alexandre E, Touboul E, Tiret E, Sezeur A, Hannoun L, Houry S, Huguet F, Pène F, Parc R, Schlienger M: [Epidermoid carcinomas of anal canal treated with radiation therapy and concomitant chemotherapy (5-fluorouracil and cisplatin)]. Cancer Radiother; 2006 Dec;10(8):572-82
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  • [Title] [Epidermoid carcinomas of anal canal treated with radiation therapy and concomitant chemotherapy (5-fluorouracil and cisplatin)].
  • [Transliterated title] Carcinomes épidermoïdes du canal anal traités par association concomitante de radiothérapie et de chimiothérapie. Evaluation des résultats fonctionnels.
  • PURPOSE: To evaluate our results after radiation therapy and concomitant chemotherapy in terms of local control, survival and toxicity in patients with anal cancer.
  • METHODS AND PATIENTS: Between November 1990 and January 2002, 60 patients (pts) were treated with radiation therapy and concomitant chemotherapy.
  • The T-stage according to the 2001 UICC classification were: 2 T1, 26 T2, 25 T3, and 7 T4.
  • The treatment started with external beam RT (median dose: 45 Gy) and concomitant chemotherapy using 5-fluorouracil and cisplatin during the first week and the fifth week of external beam RT (EBRT).
  • After a rest period of 4 to 6 weeks, a boost of 20 Gy was delivered by EBRT in 58 pts and by interstitial (192)Ir brachytherapy in 2 pts.
  • RESULTS: At the end of RT with concomitant chemotherapy local tumor clinical complete response rate was 83%.
  • The overall local tumor control (LC) rate with or without salvage local treatment were 88%.
  • LC rate with a good anal function scoring (score 0 and 1) was 70%.
  • Among 43 pts who preserved their anus, 98% had a good anal function scoring.
  • Late severe complication was observed in 3 pts: 2 pts with painful necrosis of the anus requiring colostomy and 1 pt with grade 3 rectal bleeding.
  • CONCLUSION: We confirm the good results with RT and concomitant chemotherapy.
  • The clinical tumor response after the first course of RT and concomitant chemotherapy is probably the most important predictive factor on the disease-free survival.
  • For patients with T3 or T4 lesion and tumor regression <or=50% after the first course of radiation therapy, surgical non conservative treatment should be discussed.
  • [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 / pathology. Antimetabolites, Antineoplastic / administration & dosage. Brachytherapy. Cisplatin / administration & dosage. Combined Modality Therapy. Disease-Free Survival. Female. Fluorouracil / administration & dosage. Follow-Up Studies. HIV Seropositivity. Humans. Lymphatic Metastasis. Male. Middle Aged. Multivariate Analysis. Neoplasm Recurrence, Local. Neoplasm Staging. Prognosis. Radiotherapy Dosage. Time Factors. Treatment Outcome

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  • (PMID = 17110148.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Evaluation Studies; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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6. Vuong T, Kopek N, Ducruet T, Portelance L, Faria S, Bahoric B, Devic S: Conformal therapy improves the therapeutic index of patients with anal canal cancer treated with combined chemotherapy and external beam radiotherapy. Int J Radiat Oncol Biol Phys; 2007 Apr 1;67(5):1394-400
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  • [Title] Conformal therapy improves the therapeutic index of patients with anal canal cancer treated with combined chemotherapy and external beam radiotherapy.
  • PURPOSE: To evaluate the clinical outcomes of three-dimensional conformal radiotherapy (3D-CRT) in patients with anal canal cancer, in terms of local control (LC), freedom from relapse (FFR), and overall survival (OS) rates, and to estimate long-term toxicity data.
  • Patients treated with 3D-CRT received 54 Gy in 30 fractions delivered continuously, compared with 45-58.9 Gy (median dose, 54 Gy) in a split course in patients treated with C-RT.
  • Chemotherapy consisted of 5-fluorouracil with either mitomycin-C or cis-platinum given concurrently with radiation.
  • RESULTS: No differences in stage and age distribution were observed between the two groups.
  • CONCLUSION: The use of 3D-CRT allows patients with anal canal cancer to complete radiation and chemotherapy without interruption for toxicity, with significant improvements in LC, FFR, and OS.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Radiotherapy, Conformal
  • [MeSH-minor] Aged. Cisplatin / administration & dosage. Combined Modality Therapy / methods. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Proportional Hazards Models. Radiotherapy Dosage. Survival Analysis

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  • (PMID = 17276620.001).
  • [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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7. Abramowitz L, Mathieu N, Roudot-Thoraval F, Lemarchand N, Bauer P, Hennequin C, Mitry E, Romelaer C, Aparicio T, Sobhani I: Epidermoid anal cancer prognosis comparison among HIV+ and HIV- patients. Aliment Pharmacol Ther; 2009 Aug 15;30(4):414-21
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  • [Title] Epidermoid anal cancer prognosis comparison among HIV+ and HIV- patients.
  • BACKGROUND: Previous studies suggest a poor prognosis of epidermoid anal cancer in HIV+ patients.
  • AIM: To investigate the long-term outcome of epidermoid anal cancer in HIV+ and HIV- patients in the highly active antiretroviral treatment (HAART) era.
  • METHODS: We included all patients with epidermoid anal cancer referred to six hospitals from 1998 to 2004.
  • No significant differences were observed in the tumour stage, pelvic radiotherapy dose or concomitant chemotherapy, according to the HIV status.
  • CONCLUSIONS: The clinical outcome of HIV+ patients with epidermoid anal cancer is similar to that of HIV- patients.
  • Therefore, the same therapeutic guidelines should be applied to both populations.
  • [MeSH-major] Antiretroviral Therapy, Highly Active. Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy. HIV Infections / drug therapy. HIV Seropositivity / complications
  • [MeSH-minor] Adult. Age Factors. Aged. Cohort Studies. Female. Humans. Male. Middle Aged. Prognosis. Retrospective Studies. Sex Factors. Statistics as Topic. Surveys and Questionnaires. Survival Rate. Treatment Outcome


8. Mell LK, Schomas DA, Salama JK, Devisetty K, Aydogan B, Miller RC, Jani AB, Kindler HL, Mundt AJ, Roeske JC, Chmura SJ: Association between bone marrow dosimetric parameters and acute hematologic toxicity in anal cancer patients treated with concurrent chemotherapy and intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys; 2008 Apr 1;70(5):1431-7
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  • [Title] Association between bone marrow dosimetric parameters and acute hematologic toxicity in anal cancer patients treated with concurrent chemotherapy and intensity-modulated radiotherapy.
  • PURPOSE: To test the hypothesis that the volume of pelvic bone marrow (PBM) receiving 10 and 20 Gy or more (PBM-V(10) and PBM-V(20)) is associated with acute hematologic toxicity (HT) in anal cancer patients treated with concurrent chemoradiotherapy.
  • METHODS AND MATERIALS: We analyzed 48 consecutive anal cancer patients treated with concurrent chemotherapy and intensity-modulated radiation therapy.
  • The median radiation dose to gross tumor and regional lymph nodes was 50.4 and 45 Gy, respectively.
  • Endpoints included the white blood cell count (WBC), absolute neutrophil count (ANC), hemoglobin, and platelet count nadirs.
  • RESULTS: Twenty patients (42%) had Stage T3-4 disease; 15 patients (31%) were node positive.
  • CONCLUSION: This analysis supports the hypothesis that increased low-dose radiation to PBM is associated with acute HT during chemoradiotherapy for anal cancer.
  • Techniques to limit bone marrow irradiation may reduce HT in anal cancer patients.
  • [MeSH-major] Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Bone Marrow / radiation effects
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Anemia / etiology. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy / methods. Female. Fluorouracil / administration & dosage. Humans. Leukopenia / etiology. Male. Middle Aged. Mitomycin / administration & dosage. Neutropenia / etiology. Pelvis. Radiotherapy Dosage. Radiotherapy, Intensity-Modulated. Regression Analysis. Retrospective Studies. Thrombocytopenia / etiology

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  • (PMID = 17996390.001).
  • [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; Validation Studies
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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9. 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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  • [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 early stage tumors, (192)Ir-HDR BT boost with CT resulted in a 5-year LC and CSS of 100%.
  • 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.
  • BT boost is most beneficial in early stage tumors but the advantage of BT seems to be limited due to its invasiveness, doctor dependence, and logistic circumstances.
  • [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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10. Ferrigno R, Nakamura RA, Dos Santos Novaes PE, Pellizzon AC, Maia MA, Fogarolli RC, Salvajoli JV, Filho WJ, Lopes A: Radiochemotherapy in the conservative treatment of anal canal carcinoma: retrospective analysis of results and radiation dose effectiveness. Int J Radiat Oncol Biol Phys; 2005 Mar 15;61(4):1136-42
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  • [Title] Radiochemotherapy in the conservative treatment of anal canal carcinoma: retrospective analysis of results and radiation dose effectiveness.
  • PURPOSE: This retrospective analysis reports the results on patients with anal canal carcinoma treated by combined radiotherapy and chemotherapy.
  • METHODS AND MATERIALS: Between March 1993 and December 2001, 43 patients with anal canal carcinoma were treated with radiochemotherapy at the Hospital do Cancer A.C. Camargo.
  • Stage distribution was as follows: I, 3 (7%); II, 23 (53.5%); IIIA, 8 (18.6%); and IIIB, 9 (21%).
  • The median dose of RT at the whole pelvis and at the primary tumor was 45 Gy and 55 Gy, respectively.
  • Chemotherapy was carried out during the first and last 4 days of RT with continuous infusion of 5-fluorouracil (1000 mg/m(2)) and bolus mitomycin C (10 mg/m(2)).
  • Median overall treatment time was 51 days (range, 30-129 days).
  • Patient's age, tumor stage, overall treatment time, and RT dose at primary tumor were variables analyzed for survival and local control.
  • RESULTS: Median follow-up time was 42 months (range, 4-116 months).
  • Overall survival according to clinical stage was as follows: I, 100%; II, 82%; IIIA, 73%; and IIIB, 18% (p = 0.0049).
  • According to the RT dose, local control was higher among patients who received more than 50 Gy at primary tumor (86.5% vs. 34%, p = 0.012).
  • Temporary interruption of the treatment as a result of acute toxicity was necessary in 12 patients (28%).
  • Four patients developed mild chronic complications.
  • CONCLUSIONS: This analysis suggests that the treatment scheme employed was effective for anal sphincter preservation and local control; however, the incidence of distant metastases was relatively high.
  • The clinical stage was the main prognostic factor for overall survival.
  • Local control was higher in patients treated with doses of more than 50 Gy at primary tumor.
  • [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. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Neoplasm Recurrence, Local / surgery. Radiotherapy Dosage. Retrospective Studies. Treatment Outcome

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  • (PMID = 15752894.001).
  • [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] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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11. 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).
  • The ERUS T and N stage were significant predictors of relapse (P=0.001 and P=0.03, respectively) whereas the corresponding clinical (UICC) stages were not (P = 0.4 and P = 0.5, respectively).
  • Using a Cox model, usT stage was the only significant predictive factor for patient survival.
  • [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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12. Wang JP, Ding WX, Deng YH, Lan P, Pan K, Dong GH, Deng JZ, Wang L, Wu XJ, Guo XF, Zheng J: [Preoperative chemoradiotherapy with FOLFOX in low rectal cancer: a multicenter study]. Zhonghua Wei Chang Wai Ke Za Zhi; 2008 Mar;11(2):116-9
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  • [Title] [Preoperative chemoradiotherapy with FOLFOX in low rectal cancer: a multicenter study].
  • OBJECTIVE: To investigate the toxicity and safety of FOLFOX regimen concurrent with radiotherapy in neoadjuvant setting in patients with low rectal cancer.
  • METHODS: Fifty-six patients with stage T(3-4)N(0)M(0) and T(1-4)N(1-2)M(0) were eligible from Aug.
  • Upon entry the study, they received 4 cycles of chemotherapy with FOLFOX regimen.
  • Radiotherapy was added from the second cycle of chemotherapy (CT).
  • The total dose of radiotherapy (RT) was 46 Gy (2 Gy x 23).
  • One patient stopped chemoradiotherapy(CRT) because of complicating with active pulmonary tuberculosis after 2 cycles of CT and 10 times of RT.
  • Fifty-two patients received operation after CRT, 50 with anal interior sphincter reservation, 19 with prophylactic ileac stoma.
  • CONCLUSION: Concomitant treatment of FOLFOX regimen and RT in neoadjuvant setting of rectal cancer was safe and tolerable, and it suggests that protective ileostomy for anastomotic leakage following anus-preserving operation should be performed.
  • [MeSH-major] Neoadjuvant Therapy / methods. Rectal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Female. Fluorouracil / administration & dosage. Formyltetrahydrofolates / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Organoplatinum Compounds / administration & dosage. Radiotherapy, Adjuvant. Rectum / pathology. Young Adult

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  • (PMID = 18344075.001).
  • [ISSN] 1671-0274
  • [Journal-full-title] Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery
  • [ISO-abbreviation] Zhonghua Wei Chang Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] Clinical Trial; English Abstract; Journal Article; Multicenter Study
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Formyltetrahydrofolates; 0 / Organoplatinum Compounds; 04ZR38536J / oxaliplatin; U3P01618RT / Fluorouracil
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13. Deniaud-Alexandre E, Touboul E, Tiret E, Sezeur A, Houry S, Gallot D, Parc R, Huang R, Qu SH, Huart J, Pène F, Schlienger M: Results of definitive irradiation in a series of 305 epidermoid carcinomas of the anal canal. Int J Radiat Oncol Biol Phys; 2003 Aug 1;56(5):1259-73
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  • [Title] Results of definitive irradiation in a series of 305 epidermoid carcinomas of the anal canal.
  • PURPOSE: To evaluate our data concerning the prognostic factors for locoregional control, survival, late complications, and sphincter conservation in a series of epidermoid cancers of the anal canal without clinical evidence of metastasis.
  • The T stage according to the 1987 International Union Against Cancer classification was T1 in 26, T2 in 141, T3 in 104, and T4 in 34.
  • The pretreatment anal function score, according to our in-house system, was 0 for 22 patients, 1 for 182, 2 for 74, 3 for 7, and 4 for 11 patients; for 9 patients, scores were unavailable.
  • The treatment started with external beam radiotherapy (EBRT) in 303 patients (median dose 45 Gy).
  • After a rest period of 4-6 weeks, a boost of 20 Gy was delivered by EBRT in 279 patients and by interstitial (192)Ir brachytherapy in 17 patients.
  • Seven patients received only one course of EBRT (mean dose 49.5 Gy), and 2 patients were treated with interstitial (192)Ir brachytherapy alone (55 Gy and 60 Gy).
  • Concomitant chemotherapy (5-fluorouracil and either mitomycin C or cisplatin) was delivered to 19 patients.
  • The overall local control rate (with or without salvage local therapy) was 84%.
  • The local control rate with good anal function (score 0 or 1) was 56.5%.
  • Of 181 available patients with their anus preserved, 94% had good anal function.
  • For a subgroup of 15 patients with a tumor length of <2 cm and without nodal involvement, the clinical complete response rate after RT completion was 100%, the local control rate with or without local salvage treatment was 100%, and among 13 available patients with their anus preserved, the anal function score was good in 12 patients (92%).
  • After multivariate analysis, three independent predictive factors significantly influenced disease-free survival: the interval between the two courses of RT (>38 days vs. < or =38 days, p = 0.0025), pretreatment anal function score (0 vs. 1 vs. 2 vs. 3 vs. 4, p = 4.4.10(-6)), and clinical complete response after RT completion (no complete response vs. complete response, p = 2.5.10(-14)).
  • However, to improve survival without colostomy with good anal sphincter function, chemoradiotherapy should be preferred for tumors > or =2 cm in length and for locally advanced tumors.
  • [MeSH-major] Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Anal Canal / physiopathology. Female. Humans. Male. Middle Aged. Neoplasm Metastasis. Survival Rate. Treatment Failure

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  • (PMID = 12873670.001).
  • [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
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14. Lefevre JH, Parc Y, Kernéis S, Shields C, Touboul E, Chaouat M, Tiret E: Abdomino-perineal resection for anal cancer: impact of a vertical rectus abdominis myocutaneus flap on survival, recurrence, morbidity, and wound healing. Ann Surg; 2009 Nov;250(5):707-11
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  • [Title] Abdomino-perineal resection for anal cancer: impact of a vertical rectus abdominis myocutaneus flap on survival, recurrence, morbidity, and wound healing.
  • OBJECTIVES: To evaluate the results of a vertical rectus abdominis myocutaneus (VRAM) flap after abdomino-perineal resection (APR) for anal cancer (AC).
  • BACKGROUND DATA: APR is the only curative treatment for AC that recurs or persists after radiochemotherapy.
  • To obtain a clear surgical margin, APR frequently includes a significant perineal exenteration, leaving a large defect surrounded by irradiated tissue.
  • VRAM may facilitate the healing of such a wound and, by providing tissue that can cover a large defect, can facilitate a wide resection and thus may influence survival.
  • The groups (VRAM vs. No VRAM) differed in age at surgery (56.3 vs. 62.1; P = 0.0263); administration of chemotherapy in addition to radiotherapy (81% vs. 59%; P = 0.0218); and stage (ypT3-T4 67.6% vs. 38.4%; P = 0.0394).
  • Perineal complications were significantly less frequent following VRAM (26.8% vs. 48.9%; P = 0.0336), with reduced time to healing (18.7 vs. 117 days; P = 0.0019) and the ratio of wound healing to survival time (5.6% vs. 19.4%; P = 0.0176).
  • [MeSH-major] Anus Neoplasms / surgery. Carcinoma, Squamous Cell / surgery. Postoperative Complications. Surgical Flaps. Wound Healing
  • [MeSH-minor] Digestive System Surgical Procedures. Disease-Free Survival. Female. Humans. Male. Middle Aged. Neoadjuvant Therapy. Neoplasm Recurrence, Local. Perineum / surgery. Rectus Abdominis. Survival Rate

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  • (PMID = 19801930.001).
  • [ISSN] 1528-1140
  • [Journal-full-title] Annals of surgery
  • [ISO-abbreviation] Ann. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Kiran RP, Pokala N, Rottoli M, Fazio VW: Is survival reduced for patients with anal cancer requiring surgery after failure of radiation? Analysis from a population study over two decades. Am Surg; 2009 Feb;75(2):163-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Is survival reduced for patients with anal cancer requiring surgery after failure of radiation? Analysis from a population study over two decades.
  • Chemoradiotherapy is the standard treatment for anal cancer.
  • Surgery is reserved for failure of therapy, but there are limited data examining outcomes after surgery.
  • From a prospective population-based database on radiation and surgical therapy, we compare outcomes for patients with anal cancer undergoing rectal resection after radiation with patients undergoing radiation alone.
  • Patients undergoing surgical resection of the rectum after initial radiation (SRT) for squamous cell carcinoma of the anus, anal canal, cloacogenic zone, and overlapping lesions of the rectum and anal canal from 1983 to 2002 were identified from the Surveillance, Epidemiology and End Results database.
  • SRT had more patients with regional stage of disease (66.7 vs 42.4%, P = 0.001).
  • For patients with localized stage, survival for SRT and RT was similar (105 vs 98 months, P = 0.7).
  • For patients with regional stage, survival for SRT and RT was similar (95 vs 83 months, P = 0.6).
  • Because radiation is combined with chemotherapy, this suggests that salvage surgery after failure of therapy results in outcomes comparable to combination therapy alone.
  • [MeSH-major] Anus Neoplasms / mortality. Anus Neoplasms / surgery. Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / surgery
  • [MeSH-minor] Adult. Aged. Female. Humans. Male. Middle Aged. Radiotherapy, Adjuvant. Retrospective Studies. SEER Program. Survival Rate. Treatment Failure. United States / epidemiology

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  • (PMID = 19280811.001).
  • [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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16. Webber J, Fromm D: Photodynamic therapy for carcinoma in situ of the anus. Arch Surg; 2004 Mar;139(3):259-61
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  • [Title] Photodynamic therapy for carcinoma in situ of the anus.
  • HYPOTHESIS: Photodynamic therapy (PDT) for carcinoma in situ of the anus is an alternative to surgical excision in patients who are seropositive for human immunodeficiency virus (HIV).
  • PATIENTS: Twelve HIV-seropositive patients who were actively being treated for AIDS with high-grade dysplasia on anal Papanicolaou test results had site-directed biopsies of acetowhitening foci immediately after application of dilute acetic acid.
  • Biopsy results showed that 5 patients had anal carcinoma in situ.
  • Four to 4.25 hours later, the entire anal circumference was treated with PDT.
  • MAIN OUTCOME MEASURES: Anal cytologic examination by Papanicolaou test and site-directed biopsy if acetowhitening was found at 5 months in order to determine effectiveness of PDT in downstaging cytologic findings.
  • No complications of PDT occurred, but all 5 patients developed various abnormalities in liver function test results that returned to baseline values within 2 weeks; this also has been noted in patients ingesting delta-aminolevulinic acid who are presumably HIV seronegative.
  • CONCLUSION: In a group of patients who are at high risk for recurrence irrespective of initial treatment, PDT can be used as a successful alternative to surgical excision for anal carcinoma in situ.
  • [MeSH-major] Anus Neoplasms / drug therapy. Carcinoma in Situ / drug therapy. Photochemotherapy
  • [MeSH-minor] Adult. Biopsy. Humans. Male. Middle Aged. Treatment Outcome

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  • (PMID = 15006881.001).
  • [ISSN] 0004-0010
  • [Journal-full-title] Archives of surgery (Chicago, Ill. : 1960)
  • [ISO-abbreviation] Arch Surg
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
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17. Widder J, Kastenberger R, Fercher E, Schmid R, Langendijk JA, Dobrowsky W, Pötter R: Radiation dose associated with local control in advanced anal cancer: retrospective analysis of 129 patients. Radiother Oncol; 2008 Jun;87(3):367-75
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  • [Title] Radiation dose associated with local control in advanced anal cancer: retrospective analysis of 129 patients.
  • BACKGROUND AND PURPOSE: To retrospectively analyse a large consecutive cohort of patients with anal cancer for treatment-related factors influencing local control and survival.
  • MATERIALS AND METHODS: All patients referred for primary radiotherapy at Medical University of Vienna in 1990-2002 with anal canal carcinoma without distant metastases were analysed.
  • Treatment consisted of external radiotherapy with or without brachytherapy and with or without chemotherapy.
  • Patient-, tumour-, and treatment-factors were tested for influence on survival and local control using Cox multivariate analysis.
  • RESULTS: Median age was 67 years (n=129), the UICC stage distribution was 15%, 58%, and 27% for stages I, II, and III, respectively.
  • Stage and age were significant factors for overall and colostomy-free-survival, N-stage for disease-free-survival.
  • Shorter overall treatment time favoured local control in stage T1-2 (p=.015), higher total radiation dose and female gender were associated with improved local control in T3-4 tumours (p=.021).
  • CONCLUSIONS: These results support potential improvement of anal cancer treatment by studying advanced technology such as IMRT, making it possible to tailor high-dose regions.
  • [MeSH-major] Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Radiotherapy Dosage. Survival Rate

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  • (PMID = 18501453.001).
  • [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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18. 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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  • [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).
  • RESULTS: Of 131 patients (median age, 58.3 years; median follow-up, 2.9 (range, 0.6-11.2) years), 66 percent were females, 43.5 percent were Stage II, and 11 (8 percent) were HIV-positive.
  • 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).
  • Many (44 percent Stages I/II, 48.9 percent Stage III) required dose adjustments.
  • 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.
  • On multivariate analyses, disease stage (P=0.05) and completion of radiotherapy (P=0.01) remained significant predictors of relapse-free survival.
  • 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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19. 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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  • [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.
  • There were no differences by stage at diagnosis or radiation dose received.
  • 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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20. 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.
  • AJCC T-stages were Tis (4%), T1 (8%), T2 (58%) and T3 (29%).
  • One patient had metastatic disease at diagnosis.
  • 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).
  • CONCLUSIONS: Most HIV-positive and organ transplant patients receiving radiotherapy with or without chemotherapy experience acute toxicity but few have chronic complications.
  • T-stage and CD4 level in HIV-positive patients predict for LC.
  • T-stage and TT predict for OS.
  • [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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  • [Cites] Int J Radiat Oncol Biol Phys. 2006 Sep 1;66(1):206-11 [16904522.001]
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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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21. Nguyen WD, Mitchell KM, Beck DE: Risk factors associated with requiring a stoma for the management of anal cancer. Dis Colon Rectum; 2004 Jun;47(6):843-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Risk factors associated with requiring a stoma for the management of anal cancer.
  • PURPOSE: Combination chemotherapy and radiation therapy has become the standard of care for epidermoid carcinoma of the anus.
  • This treatment modality has allowed for preservation of the anus in most patients, sparing them the morbidity of a stoma.
  • METHODS: Data on all patients with epidermoid carcinoma of the anal canal who were treated with chemoradiation with curative intent at Ochsner Clinic Foundation were entered into a prospective registry.
  • We excluded four patients who were lost to follow-up and one patient who died during chemoradiation therapy.
  • Six patients had Stage I disease, 33 patients had Stage II disease, and 12 patients had Stage III disease (N+ disease).
  • The average radiation dose was 57 +/- 17 Gy.
  • [MeSH-major] Anus Neoplasms / surgery. Carcinoma, Squamous Cell / surgery. Colostomy / methods. Neoplasm Recurrence, Local / surgery
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents / adverse effects. Colectomy. Combined Modality Therapy. Digestive System Diseases / etiology. Digestive System Diseases / surgery. Female. Humans. Male. Middle Aged. Neoplasm Staging. Neoplasm, Residual. Radiotherapy / adverse effects. Risk Factors. Surgical Stomas. Wounds and Injuries / etiology. Wounds and Injuries / surgery

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  • (PMID = 15054683.001).
  • [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 / Antineoplastic Agents
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22. Winburn GB: Anal carcinoma or "just hemorrhoids"? Am Surg; 2001 Nov;67(11):1048-58
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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.
  • At presentation nine (18%) were classified as stage 0, five (10%) stage I, 21 (42%) stage II, eight (16%) stage III, and seven (14%) stage IV.
  • 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.
  • Three of these deaths were in patients with melanoma who presented with stage IV disease.
  • 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
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Diagnosis, Differential. Female. Hemorrhoids / diagnosis. Humans. Male. Middle Aged. Neoplasm Staging. Retrospective Studies. Survival Analysis

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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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23. Staib L, Gottwald T, Lehnert T, Ruf G, Sturm J, Becker HD, Farthmann E, Herfarth C, Post S, Trede M, Beger HG: Sphincter-saving treatment in epidermoid anal cancer: cooperative analysis of 142 patients in five German university surgical centers. Int J Colorectal Dis; 2000 Nov;15(5-6):282-90
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  • [Title] Sphincter-saving treatment in epidermoid anal cancer: cooperative analysis of 142 patients in five German university surgical centers.
  • Five southern German university centers cooperated in comparing the effect of surgical vs. nonsurgical therapy strategies on survival and sphincter preservation in the treatment of anal cancer.
  • A standardized questionnaire was used to evaluate retrospectively (mean follow-up 30 months) treatment strategy and outcome (survival, colostomy rate, colostomy-free survival) in patients treated between 1987 and 1996.
  • Of the 142 patients 65% had squamous cell, 20% basaloid, 6% adeno-, and 1% undifferentiated carcinoma (8% histology not recorded); 9% were classified in UICC stage I, 37% in stage II, 25% in stage III, and 4% in stage IV (25% not recorded).
  • Primary treatment consisted of local excision (10%), excision plus radio- and/or chemotherapy (17%), radiotherapy (20%), radiochemotherapy (28%), or colostomy with or without resection, radiotherapy, and chemotherapy (23%).
  • We observed no difference between these treatment groups in overall (P = 0.43) or colostomy-free survival (P = 0.14, log-rank).
  • Mean overall survival (in months) was 42 in stage I, 38 in stage II, and 25 in stage III (P = 0.0013); mean colostomy-free survival was 36 in stage I, 26 in stage II, and 16 in stage III (P = 0.0021, log-rank).
  • Outcome was not significantly related to therapeutic strategy (surgery or radio-chemotherapy.
  • Primary surgical and nonsurgical strategies in treating anal cancer thus produced similar results, although radiochemotherapy is usually recommended for sphincter-endangering anal cancer.
  • Challenges to be met in the future include the prevention of metastasis and long-term preservation of anal sphincter function.
  • [MeSH-major] Anal Canal / surgery. Anus Neoplasms / surgery. Carcinoma, Squamous Cell / surgery
  • [MeSH-minor] Adenocarcinoma / mortality. Adenocarcinoma / surgery. Adenocarcinoma / therapy. Adult. Aged. Aged, 80 and over. Carcinoma / mortality. Carcinoma / surgery. Carcinoma / therapy. Clinical Trials as Topic. Disease-Free Survival. Female. Humans. Male. Middle Aged. Multicenter Studies as Topic. Time Factors. Treatment Outcome

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  • (PMID = 11151431.001).
  • [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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24. Seo Y, Kinsella MT, Reynolds HL, Chipman G, Remick SC, Kinsella TJ: Outcomes of chemoradiotherapy with 5-Fluorouracil and mitomycin C for anal cancer in immunocompetent versus immunodeficient patients. Int J Radiat Oncol Biol Phys; 2009 Sep 1;75(1):143-9
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  • [Title] Outcomes of chemoradiotherapy with 5-Fluorouracil and mitomycin C for anal cancer in immunocompetent versus immunodeficient patients.
  • PURPOSE: Information is limited as to how we should treat invasive anal squamous cell carcinoma (SCC) in patients with chronic immunosuppression, since the majority of clinical studies to date have excluded such patients.
  • The objective of this study is to compare treatment outcomes in immunocompetent (IC) versus immunodeficient (ID) patients with invasive anal SCC treated similarly with combined modality therapy.
  • There were no significant differences in tumor size, T stage, N stage, chemotherapy doses, or radiation doses between the two groups.
  • CONCLUSION: Our data suggest that standard combined modality therapy with three-dimensional conformal radiotherapy and 5-fluorouracil plus mitomycin C is as safe and effective for ID patients as for IC patients.
  • [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] Adult. Aged. Aged, 80 and over. CD4 Lymphocyte Count. Colostomy / mortality. Combined Modality Therapy / methods. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Follow-Up Studies. HIV Seropositivity / immunology. HIV Seropositivity / mortality. Humans. Immunocompetence. Immunocompromised Host. Male. Middle Aged. Mitomycin / administration & dosage. Mitomycin / adverse effects. Proportional Hazards Models. Radiotherapy Dosage. Survival Analysis. Transplantation Immunology. Treatment Outcome

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  • (PMID = 19203845.001).
  • [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] Comparative Study; Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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25. 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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26. Phang PT, MacFarlane JK, Taylor RH, Cheifetz RE, Davis N, Hay JH, McGregor G, Speers C, Sullivan BJ, Pitts J, Coldman AJ: Effects of positive resection margin and tumor distance from anus on rectal cancer treatment outcomes. Am J Surg; 2002 May;183(5):504-8
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  • [Title] Effects of positive resection margin and tumor distance from anus on rectal cancer treatment outcomes.
  • PURPOSE: Rectal cancer outcome depends on stage, technical aspects of surgical excision, and use of adjuvant chemoradiation.
  • Here, we examine effects of positive resection margin and tumor distance from the anus in stage 2 and 3 cancers on 4-year disease-specific survival and recurrence.
  • METHODS: We reviewed all 495 rectal cancer patients registered in British Columbia in 1996.
  • RESULTS: There were 481 cases analyzed: 29 in situ, 134 stage 1, 107 stage 2, 100 stage 3, 83 stage 4, and 28 unknown stage.
  • Survival was significantly affected by presence of positive resection margin in stage 2 and 3 cancers, P = 0.0001.
  • Lower tumor distance from the anus for stage 2 and 3 cancers worsened survival, P = 0.0007, and overall recurrence, P =0.016, but not local recurrence, P = 0.11.
  • Adjuvant postoperative combined radiation and chemotherapy in stage 2 and 3 cancers significantly improved survival, P = 0.070 and local recurrence, P = 0.018, but not overall recurrence, P = 0.19.
  • CONCLUSIONS: Presence of positive resection margin and tumor distance from the anus affect survival, local recurrence, and overall recurrence.
  • Adjuvant postoperative combined radiation and chemotherapy improved our outcomes.
  • Improved surgical excision and use of adjuvant preoperative radiation and chemotherapy may improve outcome.
  • [MeSH-minor] Combined Modality Therapy. Humans. Neoplasm Recurrence, Local. Neoplasm Staging. Prognosis. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 12034381.001).
  • [ISSN] 0002-9610
  • [Journal-full-title] American journal of surgery
  • [ISO-abbreviation] Am. J. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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27. Graf R, Wust P, Hildebrandt B, Gögler H, Ullrich R, Herrmann R, Riess H, Felix R: Impact of overall treatment time on local control of anal cancer treated with radiochemotherapy. Oncology; 2003;65(1):14-22
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  • [Title] Impact of overall treatment time on local control of anal cancer treated with radiochemotherapy.
  • Between 1987 and 2000, 111 patients with epidermoid anal cancer (T1-T4 Nx M0) were assigned to primary simultaneous radiochemotherapy (RCT) with a radiation dose of 45 Gy, performed either as a split course with 2-Gy single fractions (schedule A, 1987-1996, n = 65 patients) or continuously with fractions of 1.8 Gy (schedule B, 1996-2000; n = 38 patients).
  • The chemotherapy consisted of continuous infusions of 5-fluorouracil (5-FU; 800/1,000 mg/m(2)/day, on 4/5 consecutive days, during weeks 1 and 5) together with one (schedule A) or two (schedule B) short infusions of mitomycin C (10 mg/m(2)) during the first course of 5-FU.
  • Advanced tumor stage, size, and nodal status significantly decreased the 5-year local control rate as well as the overall treatment time (OTT) >41 days (58% for OTT >41 days vs. 79% for OTT < or =41 days; p = 0.04).
  • In conclusion, in patients with anal carcinomas treated with RCT with a radiation dose of 45 Gy, the predominant determinant of local control is the resulting OTT and not the administration schedule (split course or continuous radiotherapy).
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Anus Neoplasms / mortality. Carcinoma, Adenosquamous / mortality. Carcinoma, Squamous Cell / mortality. Carcinoma, Transitional Cell / mortality. Neoplasm Recurrence, Local / mortality
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Disease-Free Survival. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Mitomycin / administration & dosage. Radiation Dosage. Survival Analysis. Switzerland. Treatment Outcome

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  • [Copyright] Copyright 2003 S. Karger AG, Basel
  • (PMID = 12837978.001).
  • [ISSN] 0030-2414
  • [Journal-full-title] Oncology
  • [ISO-abbreviation] Oncology
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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28. Myerson RJ, Outlaw ED, Chang A, Birnbaum EH, Fleshman JW, Grigsby PW, Kodner IJ, Malayapa RS, Mutch MG, Parikh P, Picus J, Tan BR: Radiotherapy for epidermoid carcinoma of the anus: thirty years' experience. Int J Radiat Oncol Biol Phys; 2009 Oct 1;75(2):428-35
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  • [Title] Radiotherapy for epidermoid carcinoma of the anus: thirty years' experience.
  • PURPOSE: To evaluate the factors associated with disease control and morbidity after radiotherapy for anal carcinoma.
  • METHODS AND MATERIALS: Between 1975 and 2005, 194 patients with localized epidermoid anal carcinoma underwent radiotherapy.
  • Treatment evolved from radiotherapy with or without surgery, to preoperative chemoradiotherapy, to definitive chemoradiotherapy (CRT).
  • Univariate analysis for UNED survival showed a strong association with the T and N stage (5-year UNED rate, 88.5% +/- 3.4% for those with Stage T1-T2N0; 70.1% +/- 4.2% for Stage T3N0; and 52.7% +/- 6.6% for Stage III; p > .001) and mobility on palpation (5-year UNED rate, 89.2% +/- 4.6% for those with mobile tumors vs. 59.3% +/- 6.1% for those with tethered/fixed tumor; p > .001).
  • No association was found with gender, age, preoperative vs. definitive CRT, or human immunodeficiency virus status.
  • The radiotherapy factors associated with Grade 3 or greater late morbidity included anorectal morbidity with tumor dose (29% with a dose > or =55 Gy vs. 9% otherwise), small bowel injury with technique (9% with anteroposterior-posteroanterior supine vs. 0.7% with multiple fields prone), and bone injury with femoral head dose (9% with a dose of > or =44 Gy vs. 0.7% otherwise).
  • Of the 194 patients, 56 had 68 additional malignancies, mainly either antedating the anal cancer or outside the radiation fields.
  • We also discuss the treatment planning implications of the late morbidity findings.
  • [MeSH-major] Anus Neoplasms / drug therapy. Anus Neoplasms / radiotherapy. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Analysis of Variance. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy / methods. Combined Modality Therapy / trends. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. HIV Seropositivity / complications. Hospitals, University. Humans. Male. Middle Aged. Missouri. Mitomycin / administration & dosage. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / radiotherapy. Neoplasm Staging. Neoplasms, Multiple Primary / pathology. Neoplasms, Radiation-Induced / pathology. Radiation Injuries / pathology. Radiotherapy Dosage. Salvage Therapy / methods

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  • (PMID = 19251377.001).
  • [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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29. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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).
  • Only T-stage and tumor invasion (uT) proved significant prognostic variables.
  • 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

  • Genetic Alliance. consumer health - Epidermoid Carcinoma.
  • MedlinePlus Health Information. consumer health - Anal Cancer.
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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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30. Rogers LJ, Howard B, Van Wijk L, Wei W, Dehaeck K, Soeters R, Denny LA: Chemoradiation in advanced vulval carcinoma. Int J Gynecol Cancer; 2009 May;19(4):745-51
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Chemoradiation in advanced vulval carcinoma.
  • INTRODUCTION: Vulval carcinoma is uncommon, affecting approximately 2 per 100,000 women annually.
  • The treatment of choice is radical vulvectomy and inguinal lymph node dissection.
  • Advanced vulval carcinomas involve midline structures (such as clitoris, urethra, or anus) and/or adjacent pelvic organs or bone, and adequate excision may require urinary diversion, colostomy, or pelvic exenteration.
  • Less morbid and less mutilating therapeutic alternatives have been investigated, particularly chemoradiation, which has shown success in the management of anal carcinomas.
  • This is a retrospective study of the GSH's experience of the use of chemoradiation as primary therapy for women with advanced vulval carcinoma.
  • Other prognostic factors for survival were performance status and tumor stage.
  • Performance status, age, and tumor stage were also associated with survival.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Vulvar Neoplasms / drug therapy. Vulvar Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Middle Aged. Mitomycin / administration & dosage. Neoplasm Staging. Retrospective Studies. Treatment Outcome

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  • (PMID = 19509582.001).
  • [ISSN] 1525-1438
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; U3P01618RT / Fluorouracil
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