Long-term results of weekly/daily cisplatin-based chemoradiation for locally advanced squamous cell carcinoma of the anal canal

Cathy Eng, George J. Chang, Y. Nancy You, Prajnan Das, Yan Xing, Marc Delclos, Robert A. Wolff, Miguel A. Rodriguez-Bigas, John Skibber, Aki Ohinata, Spencer Gould, Jonathan Phillips, Christopher H. Crane

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

BACKGROUND Weekly or daily cisplatin and 5-fluorouracil (5-FU)-based chemoradiation was evaluated for patients with locally advanced squamous cell carcinoma (SCC) of the anal canal treated at a single institution over a 20-year period. METHODS A retrospective, single-institution analysis was conducted of patients receiving concurrent 5-FU/cisplatin and radiotherapy for locally advanced SCC from 1989 to 2009. Endpoints included clinical complete response rate, local recurrence rate, colostomy-free survival, disease-free survival (DFS), overall survival, and treatment-related toxicity. RESULTS A total of 197 patients were evaluable. The majority had American Joint Committee on Cancer stage II (41%) or stage III (46%) disease; most were T2 (44%) or T3 (27%); bulky nodal disease (N2-N3) was noted in 24% of patients. Patients received weekly (20 mg/m2) or daily (4 mg/m2) cisplatin during radiotherapy. Median radiation dose was 55 Gy. Clinical complete response was observed in 185 patients (94%). After a median follow-up of 8.6 years, local recurrence rate was 11%. Sixteen patients (8%) developed distant metastases. The 5-year DFS was 81%, the 5-year overall survival was 86%, and the 5-year colostomy-free survival was 88%. By univariate analysis, N-stage was a poor prognostic indicator for 5-year DFS (P =.02, 95% confidence interval = 1.17-2.01) and distant metastases (P =.046, 95% confidence interval = 1.09-2.13). Increased T-stage correlated with the necessity for salvage surgery (P =.01). CONCLUSIONS The combination of weekly/daily cisplatin and 5-FU-based chemotherapy with concurrent radiotherapy is an effective regimen, and our long-term results indicate that cisplatin is an alternative to mitomycin C and may be considered for the treatment of locally advanced SCC of the anal canal. Cancer 2013;119:3769-3775.

Original languageEnglish (US)
Pages (from-to)3769-3775
Number of pages7
JournalCancer
Volume119
Issue number21
DOIs
StatePublished - Nov 1 2013

Keywords

  • anal carcinoma
  • chemoradiation
  • cisplatin
  • combined therapy
  • outcomes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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