PMID- 29907489
OWN - NLM
STAT- MEDLINE
DCOM- 20190517
LR  - 20190517
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 102
IP  - 1
DP  - 2018 Sep 1
TI  - Extended-Field Chemoradiation Therapy for Definitive Treatment of Anal Canal 
      Squamous Cell Carcinoma Involving the Para-Aortic Lymph Nodes.
PG  - 102-108
LID - S0360-3016(18)30754-5 [pii]
LID - 10.1016/j.ijrobp.2018.04.076 [doi]
AB  - PURPOSE: To report cancer control rates and adverse events (AEs) of 
      curative-intent, extended-field chemoradiation therapy administered to patients 
      with squamous cell carcinoma (SCC) of the anal canal presenting with distant 
      metastasis limited to the para-aortic (PA) lymph nodes. METHODS: This was a 
      retrospective review of patients with SCC of the anal canal metastatic to the PA 
      lymph nodes at initial diagnosis who were treated with curative-intent, 
      extended-field chemoradiation therapy between September 2002 and February 2016 at 
      two tertiary care centers. Outcomes assessed included treatment-related AEs 
      (Common Terminology Criteria for Adverse Events, version 4.0), disease control 
      (cumulative incidence estimates), and survival (Kaplan-Meier estimates). RESULTS: 
      Thirty patients were included. Involved and elective PA nodes were treated to 
      median doses of 51 Gy (range 45-57.6) and 45 Gy (range 30.6-50.4) in 29 fractions 
      (range 17-32). All patients received one of these concomitant regimens: 6 weekly 
      cycles of cisplatin with 5-fluoruracil/capecitabine (5-FU) (n = 22), 2 cycles of 
      mitomycin-C with 5-FU (n = 7), or daily capecitabine (n = 1). After a median 
      follow-up period of 3.1 years, 18 patients (60%) remained alive and 17 patients 
      were without evidence of anal cancer after definite and salvage treatments. 
      Overall and disease-free survival at 3 years was 67% (95% CI 49%-89%) and 42% 
      (95% CI 25%-69%). Fifteen (50%) patients experienced a recurrence at a median of 
      0.9 year (range 0.5-3.5 years). The predominant site of recurrence was distant 
      metastases, with a 3-year cumulative incidence of 50% (95% CI 20%-68%). There was 
      no acute grade 5 AE. Grade 3 to 4 gastrointestinal, dermatologic, and hematologic 
      AEs occurred in 30%, 27%, and 20% of patients respectively. CONCLUSIONS: 
      Extended-field chemoradiation therapy is a potentially curative treatment option 
      for patients presenting with SCC of the anal canal with metastases limited to the 
      PA lymph nodes.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Holliday, Emma B
AU  - Holliday EB
AD  - Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas.
FAU - Lester, Scott C
AU  - Lester SC
AD  - Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.
FAU - Harmsen, W Scott
AU  - Harmsen WS
AD  - Department of Biostatistics, Mayo Clinic, Rochester, Minnesota.
FAU - Eng, Cathy
AU  - Eng C
AD  - Department of Gastrointestinal Oncology, MD Anderson Cancer Center, Houston, 
      Texas.
FAU - Haddock, Michael G
AU  - Haddock MG
AD  - Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.
FAU - Krishnan, Sunil
AU  - Krishnan S
AD  - Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas.
FAU - Das, Prajnan
AU  - Das P
AD  - Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas.
FAU - Hallemeier, Christopher L
AU  - Hallemeier CL
AD  - Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas. 
      Electronic address: Hallemeier.Christopher@mayo.edu.
LA  - eng
PT  - Journal Article
DEP - 20180505
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anus Neoplasms/*pathology/*therapy
MH  - *Aorta
MH  - Carcinoma, Squamous Cell/*pathology/*therapy
MH  - *Chemoradiotherapy/adverse effects
MH  - Female
MH  - Humans
MH  - Lymphatic Metastasis
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Safety
MH  - Survival Analysis
EDAT- 2018/06/17 06:00
MHDA- 2019/05/18 06:00
CRDT- 2018/06/17 06:00
PHST- 2017/12/14 00:00 [received]
PHST- 2018/04/09 00:00 [revised]
PHST- 2018/04/25 00:00 [accepted]
PHST- 2018/06/17 06:00 [pubmed]
PHST- 2019/05/18 06:00 [medline]
PHST- 2018/06/17 06:00 [entrez]
AID - S0360-3016(18)30754-5 [pii]
AID - 10.1016/j.ijrobp.2018.04.076 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2018 Sep 1;102(1):102-108. doi: 
      10.1016/j.ijrobp.2018.04.076. Epub 2018 May 5.