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Clinical Trial
. 2023 Jan 20;64(1):154-161.
doi: 10.1093/jrr/rrac069.

A phase II study of concurrent chemoradiotherapy with 5-fluorouracil and mitomycin-C for squamous cell carcinoma of the anal canal (the JROSG 10-2 trial)

Keiko Nemoto Murofushi  1 , Satoshi Itasaka  2 , Mototsugu Shimokawa  3 , Yuji Murakami  4 , Takaya Yamamoto  5 , Yasumasa Nishimura  6 , Shigehiro Kudo  7 , Takashi Sakamoto  8 , Takuro Ariga  9   10 , Etsuyo Ogo  11 , Kentaro Taguchi  1 , Keiichi Jingu  5 , Kazuhiko Ogawa  12
Affiliations
Clinical Trial

A phase II study of concurrent chemoradiotherapy with 5-fluorouracil and mitomycin-C for squamous cell carcinoma of the anal canal (the JROSG 10-2 trial)

Keiko Nemoto Murofushi et al. J Radiat Res. .

Abstract

This study assessed the efficacy of chemoradiotherapy for squamous cell carcinoma of the anal canal (SCCAC). Patients with T1-4N0-3M0 SCCAC received chemoradiotherapy with 5-fluorouracil (5-FU, 800 mg/m2/day, 96-h infusion) and mitomycin-C (MMC, 10 mg/m2 bolus). Patients treated with 3-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) were administered 36.0 Gy in 20 fractions or 49.5 Gy in 33 fractions for elective nodal irradiation and 59.4 Gy in 33 fractions for primary tumor and metastatic nodal irradiation. The sample size was considered sufficient to estimate 95% confidence intervals (CIs) for the true 2-year disease-free survival (DFS) within a width of +15% when the expected true 2-year DFS was 70%. The primary endpoint was 2-year DFS. The secondary endpoints were 2-year overall survival (OS), locoregional control (LC), colostomy-free survival (CFS) and adverse events. Thirty-one patients were enrolled between January 2014 and July 2019. The median follow-up was 33.3 months (range, 16.2-65.8 months). Among the 31 patients, 13%, 32%, 16% and 39% had stage I, II, IIIA and IIIB disease, respectively. Thirty patients were treated with IMRT. Complete response (CR) was achieved in 27 patients. The 2-year DFS, OS, LC and CFS rates were 77.4% (95% CI, 58.4-88.5%), 93.5% (95% CI, 76.6-98.3%), 83.9% (95% CI, 65.5-92.9%) and 80.6% (95% CI, 61.9-90.8%), respectively. One patient experienced grade 3 late adverse events; however, no grade ≥ 4 late adverse events occurred. Good DFS with a low rate of late adverse events was observed. Chemoradiotherapy with 5-FU and MMC was effective for SCCAC.

Keywords: 3-dimensional conformal radiotherapy (3D-CRT); anal canal cancer; chemoradiation; intensity-modulated radiotherapy (IMRT); phase II clinical trial.

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Figures

Fig. 1
Fig. 1
Disease-free survival (DFS) (A), overall survival (OS) (B), local control (LC) (C) and colostomy-free survival (CFS) (D).
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