Division of Abdominal Tumor Multimodlity, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, China.
Abdominal Oncology Ward, Division of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, China.
Clin Transl Oncol. 2024 Mar;26(3):739-746. doi: 10.1007/s12094-023-03296-1. Epub 2023 Aug 11.
To evaluate the efficacy and safety of capecitabine/cisplatin (XP) combined with intensity-modulated radiation therapy (IMRT) in patients with non-metastatic anal squamous cell carcinoma (ASCC).
All patients with ASCC who received radical concurrent chemoradiotherapy in the past 8 years were screened. Patients who received XP or mitomycin/5-fluorouracil (MF) were selected and analyzed retrospectively.
ASCC is an uncommon cancer, there were 36 patients were included in our study. The XP group and MF group included 18 patients each. The clinical complete response (cCR) rates in the XP group and the MF group were 94.4% and 88.9%, respectively (P = 1). The 2-year local control (LC), disease-free survival (DFS), and colostomy-free survival (CFS) rates were higher in the XP group than in the MF group (100% vs 93.3%, P = 0.32). Hematologic toxicities, especially grade ≥ 3 leukopenia (11.1% vs 44.4%, P = 0.06) and neutropenia (5.6% vs 61.1%, P = 0.001), were lower in the XP group than MF group. As a result of fewer side effects, fewer patients in the XP group demanded the dose reduction of chemotherapy (11.1% vs 50%, P = 0.03) and radiation interruption (55.6% vs 77.8%, P = 0.289). Delayed radiotherapy was shorter in the XP group (2.5 vs 6.5 days, P = 0.042) than in the MF group.
The XP regimen was as effective as the MF regimen in non-metastatic ASCC. Compared with the standard MF regimen, XP combined with IMRT showed higher treatment completion and lower toxicities. It could be considered a feasible alternative for patients with non-metastatic ASCC.
评估卡培他滨/顺铂（XP）联合调强放疗（IMRT）在非转移性肛门鳞癌（ASCC）患者中的疗效和安全性。
筛选了过去 8 年接受根治性同步放化疗的所有 ASCC 患者。选择并回顾性分析了接受 XP 或丝裂霉素/5-氟尿嘧啶（MF）治疗的患者。
ASCC 是一种罕见的癌症，本研究共纳入 36 例患者。XP 组和 MF 组各 18 例。XP 组和 MF 组的临床完全缓解（cCR）率分别为 94.4%和 88.9%（P=1）。XP 组的 2 年局部控制（LC）、无病生存（DFS）和结肠造口术无生存（CFS）率均高于 MF 组（100% vs 93.3%，P=0.32）。XP 组血液学毒性，特别是≥3 级白细胞减少（11.1% vs 44.4%，P=0.06）和中性粒细胞减少（5.6% vs 61.1%，P=0.001）低于 MF 组。由于副作用较少，XP 组要求减少化疗剂量（11.1% vs 50%，P=0.03）和放疗中断（55.6% vs 77.8%，P=0.289）的患者较少。XP 组延迟放疗时间短于 MF 组（2.5 vs 6.5 天，P=0.042）。
XP 方案在非转移性 ASCC 中的疗效与 MF 方案相当。与标准 MF 方案相比，XP 联合 IMRT 具有更高的治疗完成率和更低的毒性。对于非转移性 ASCC 患者，它可以被认为是一种可行的替代方案。
