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. 2017 Apr;8(2):361-367.
doi: 10.21037/jgo.2017.03.09.

Concurrent chemoradiation with volumetric modulated Arc therapy of patients treated for anal cancer-acute toxicity and treatment outcome

Kaloyan Yordanov  1 , Simona Cima  1 , Antonella Richetti  1 , Gianfranco Pesce  1 , Francesco Martucci  1 , Ngwa Che Azinwi  1 , Maria Carla Valli  1
Affiliations

Concurrent chemoradiation with volumetric modulated Arc therapy of patients treated for anal cancer-acute toxicity and treatment outcome

Kaloyan Yordanov et al. J Gastrointest Oncol. 2017 Apr.

Abstract

Background: to report the acute toxicity and clinical results in patients with anal cancer treated with volumetric modulated arc therapy (VMAT) concomitant with chemotherapy.

Methods: A cohort of 21 patients with histologically confirmed squamous cell carcinoma of the anal canal was treated with VMAT and chemotherapy. Dose prescription was 39.6 Gy, 1.8 Gy/ fraction for the elective nodal PTV, the macroscopic (tumor and involved lymph nodes) PTV doses were 14.4 Gy up to a total dose of 54 Gy in 4 patients and 19.8 up to 59.4 Gy in 15 patients. One patient received a boost dose of 18 Gy up to a total dose of 57.6 Gy and another one was treated with 36 Gy and boost of 19.8 Gy up to a total dose of 55.8 Gy. Chemotherapy with MMC and 5-FU/Capecitabine was administered concomitantly. End points were local control (LC), disease-free survival (DFS) and overall survival (OS).

Results: Median follow-up time was 35.5 months. Two year OS was 91%, DFS was 73% and LRC was 81%. Acute dermatological toxicity G3 was recorded in one patient, ten patients (47.6%) experienced a G2 skin toxicity, while G1 toxicity was registered in eight patients (38%). One patient developed Grade 3 acute gastrointestinal (GI) toxicity, two patients (9.5%) experienced grade 2 acute GI toxicity and ten patients (47.6%) G1 toxicity. Acute genitourinary toxicity G1 was recorded in ten patients (47.6%).

Conclusions: Our results support VMAT as standard radiotherapy technique in the treatment of patients with anal cancer.

Keywords: Chemoradiation; anal cancer; results; volumetric modulated arc therapy (VMAT).

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Two years overall survival (OS).
Figure 2
Figure 2
Two years disease-free survival (DFS).
Figure 3
Figure 3
Two years local control (LC).
See this image and copyright information in PMC

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