Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun-gun, Jeollanam-do, Korea.
Yonsei Med J. 2013 Jan 1;54(1):108-15. doi: 10.3349/ymj.2013.54.1.108.
The aim of this study was to evaluate long-term oncologic outcomes after concurrent chemoradiation treatment for anal cancer.
Between January 1979 and December 2008, the records of 50 consecutive patients with anal cancer and who were treated by chemoradiation or radiation only with a curative intent were retrospectively reviewed. The oncologic outcomes and the risk factors for recurrence were analyzed.
Of the 50 patients, 49 underwent concurrent chemoradiation and one underwent radiation only. After these definitive treatments, 43 (86.0%) achieved a clinical complete response. During the median follow-up of 60 months (range: 2-202 months), the 5-year overall survival, disease-free survival, and locoregional recurrence-free survival were 84.2%, 72.7%, and 69.9%, respectively. Multivariate analysis revealed that the performance status (p=0.031) and a clinical complete response (p=0.039) were the independent predictors for overall survival; lymph node involvement (p=0.031) was the only independent predictor for disease-free survival.
The performance status and a clinical complete response may be reliable predictors of survival after chemoradiation for anal cancer. The addition of irradiation to the inguinal area may not be significantly associated with the outcomes.
本研究旨在评估同步放化疗治疗肛门癌的长期肿瘤学结果。
1979 年 1 月至 2008 年 12 月期间,回顾性分析了 50 例连续接受以根治为目的的放化疗或单纯放疗的肛门癌患者的病历。分析了肿瘤学结果和复发的危险因素。
50 例患者中,49 例接受了同步放化疗,1 例仅接受了放疗。这些确定性治疗后,43 例(86.0%)达到了临床完全缓解。在中位随访 60 个月(范围:2-202 个月)期间,5 年总生存率、无病生存率和局部区域无复发生存率分别为 84.2%、72.7%和 69.9%。多因素分析显示,体力状况(p=0.031)和临床完全缓解(p=0.039)是总生存率的独立预测因素;淋巴结受累(p=0.031)是无病生存率的唯一独立预测因素。
体力状况和临床完全缓解可能是肛门癌放化疗后生存的可靠预测因素。在腹股沟区域增加照射可能与结果无显著相关性。