Department of Radiation Oncology, Kindai University of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
Department of Radiology, Ujitakeda Hospital, Uji, Kyoto, Japan.
Int J Clin Oncol. 2018 Dec;23(6):1121-1126. doi: 10.1007/s10147-018-1316-1. Epub 2018 Jul 10.
Chemoradiotherapy (CRT) is a standard treatment for anal canal cancer although many patients with anal canal cancer undergo surgery in Japan. The efficacy of CRT for anal canal cancer was evaluated retrospectively.
Medical charts of 13 patients with anal canal cancer treated by definitive CRT from October 2004 to May 2016 were reviewed. Twelve patients had squamous cell carcinoma and one had adeno-squamous carcinoma. PET/CT simulation was performed in nine patients. The median total dose was 59.4 Gy (range 57.6-63.4 Gy) with fractions of 1.8-2.0 Gy. Ten patients received chemotherapy with mitomycin C (10 mg/m) and fluorouracil (5-FU) (800 mg/m over 4 days) in weeks 1 and 5, while two patients were treated with cisplatin (40 mg) and 5-FU (750 mg over 5 days) in weeks 1 and 5. One elderly patient received radiotherapy (RT) alone.
All 13 patients were alive after a median follow-up period of 102 months (range 16-121 months). Local failure only occurred in the patient with adeno-squamous cell carcinoma, while there was no loco-regional recurrence or distant metastasis in the other 12 patients. The 5-year loco-regional control rate (LRC) and 5-year overall survival rate (OS) were 92% and 100%, respectively. Acute toxicities of ≥ grade 3 were observed in six patients (46%), mainly being dermatitis around the anal verge, and late toxicity of ≥ grade 3 occurred in one patient.
CRT for squamous cell carcinoma of the anal canal achieved good LRC and OS with acceptable toxicities.
尽管日本有许多肛管癌患者接受手术治疗，但放化疗（CRT）仍是肛管癌的标准治疗方法。本研究回顾性评估了 CRT 治疗肛管癌的疗效。
回顾性分析 2004 年 10 月至 2016 年 5 月期间 13 例接受根治性 CRT 的肛管癌患者的病历。12 例患者为鳞状细胞癌，1 例为腺鳞癌。9 例患者行 PET/CT 模拟。中位总剂量为 59.4 Gy（范围 57.6-63.4 Gy），分割剂量为 1.8-2.0 Gy。10 例患者接受每周顺铂（40 mg）和氟尿嘧啶（750 mg，5 天）与每周米托蒽醌（10 mg/m2）和氟尿嘧啶（800 mg/m2，4 天）化疗方案，2 例患者接受每周顺铂（40 mg）和氟尿嘧啶（5-FU）（800 mg/m2，4 天）化疗方案。1 例老年患者仅接受放疗。
中位随访 102 个月（范围 16-121 个月）后，13 例患者全部存活。仅 1 例腺鳞癌患者发生局部失败，12 例患者无局部区域复发或远处转移。5 年局部区域控制率（LRC）和 5 年总生存率（OS）分别为 92%和 100%。6 例（46%）患者出现≥3 级急性毒性，主要为肛门周围皮炎，1 例患者出现≥3 级晚期毒性。
CRT 治疗肛管鳞状细胞癌可获得良好的 LRC 和 OS，且毒性可接受。
