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肛管鳞状细胞癌患者的根治性放疗:一项回顾性队列研究

Definitive Radiotherapy for Patients With Anal Squamous Cell Carcinoma: A Retrospective Cohort Study.

作者信息

Katano Atsuto, Yamashita Hideomi

机构信息

Radiology, The University of Tokyo Hospital, Tokyo, JPN.

出版信息

Cureus. 2021 Oct 13;13(10):e18732. doi: 10.7759/cureus.18732. eCollection 2021 Oct.

Abstract

Background Anal squamous cell carcinoma accounts for less than 2-3% of all digestive system carcinomas. The present study aimed to determine the clinical characteristics, treatment patterns, and treatment outcomes of patients at our institution. Methodology We reviewed the clinical data of all consecutive patients with anal squamous cell carcinoma who were treated with definitive radiotherapy in our department between July 2009 and July 2020. Radiotherapy was delivered in 1.8-2 Gy daily fractions to a whole pelvic dose ranging from 45 to 50 Gy, followed by boost radiotherapy of 10-15 Gy, resulting in a total dose of approximately 60 Gy. Concurrent chemotherapy with radiotherapy included 5-fluorouracil/mitomycin C or 5-fluorouracil/cisplatin. Results A total of 14 patients with a median age of 61.5 years (range: 45-85 years) were analyzed. There were nine women and five men. The clinical T stage was T1 in two patients, T2 in six patients, T3 in two patients, and T4 in four patients. The clinical N stage was N0 in four patients and N1 in 10 patients. Patients with clinical stage III disease comprised 79% of the entire study population. For the entire cohort, the five-year overall survival rate was 83.3% and the five-year progression-free survival rate was 48.5%. One patient experienced grade 3 fecal incontinence, and the others experienced no radiation-induced severe delayed adverse events. Conclusions The results of our study demonstrated that definitive radiotherapy with or without chemotherapy for patients with anal squamous cell carcinoma is an effective and feasible treatment.

摘要

背景 肛管鳞状细胞癌占所有消化系统癌的比例不到2 - 3%。本研究旨在确定我院患者的临床特征、治疗模式及治疗结果。方法 我们回顾了2009年7月至2020年7月期间在我科接受根治性放疗的所有连续性肛管鳞状细胞癌患者的临床资料。放疗采用每日分次剂量1.8 - 2 Gy,全盆腔剂量范围为45至50 Gy,随后进行10 - 15 Gy的追加放疗,总剂量约为60 Gy。放疗同步化疗方案包括5 - 氟尿嘧啶/丝裂霉素C或5 - 氟尿嘧啶/顺铂。结果 共分析了14例患者,中位年龄为61.5岁(范围:45 - 85岁)。其中女性9例、男性5例。临床T分期为T1期2例、T2期6例、T3期2例、T4期4例;临床N分期为N0期4例、N1期10例。临床Ⅲ期疾病患者占整个研究人群的79%。整个队列的五年总生存率为83.3%,五年无进展生存率为48.5%。1例患者出现3级大便失禁,其他患者未发生放疗引起的严重迟发性不良事件。结论 我们的研究结果表明,肛管鳞状细胞癌患者接受含或不含化疗的根治性放疗是一种有效且可行的治疗方法。

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