Fokdal Lars, Mortensen Bjarke, Jensen Lars Henrik, Sørensen Mette Møller, Mc Ilroy Sean Patrick, Havelund Birgitte Mayland
Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Denmark; Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark; Radiotherapy Research Team, Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Denmark.
Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Denmark; Radiotherapy Research Team, Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Denmark.
Acta Oncol. 2024 Aug 8;63:642-648. doi: 10.2340/1651-226X.2024.40199.
Squamous cell carcinoma of the anal margin (SCCAM) is an uncommon lesion that comprises one-third to a quarter of all anal squamous cell carcinoma. Treatment involves surgery or exclusive radiotherapy for small tumours, whereas the preferred treatment for larger tumours is chemoradiotherapy. In our department, selected patients with SCCAM are treated with electron beam radiotherapy using one perineal field. The present study evaluates this strategy.
All consecutive patients with SCCAM and treated with electron beam radiotherapy from 2012 to 2022 were included. Data were retrospectively extracted from the medical records and analysed descriptively. Local control (LC) and overall survival (OS) were analysed using Kaplan-Meier statistics.
Forty patients were evaluated. Primary radiotherapy was delivered in 35 (87.5%) patients. Five (12.5%) patients had postoperative radiotherapy. Median prescription dose was 60.0 (range 45.0-60.2) Gy in 28 (range 10-30) fractions delivered with 8 (range 4-18) MeV using a standard circular aperture and bolus. At a median follow-up of 73 (range 9-135) months, 7 (17.5%) patients were diagnosed with local recurrences. The 5-year LC rate was 84.3% (95% CI: 71.4%-97.2%). Analysis of LC according to T-stage revealed a 5-year LC of 100% (95% CI: 100%-100%) in T1 tumours compared to 57.0% (95% CI: 27.4%-86.6%) in T2 tumours (p < 0.001). 5-year OS was 91.6% (95% CI: 83.0%-100%). Late grade 3 toxicity included ulceration in the skin and subcutis in 2 (5.0%) patients.
Electron beam radiotherapy enables the delivery of 'eye-guided' radiotherapy directly to the tumour. LC is good in patients with T1 tumours. Patients with T2 tumours have less satisfactory LC and should be treated with chemoradiotherapy. Electron beam radiotherapy enables the delivery of "eye-guided" RT directly to the tumour. LC is excellent in patients with T1 tumours. Patients with T2 tumours have less satisfactory LC and should be treated with chemoradiotherapy.
肛管边缘鳞状细胞癌（SCCAM）是一种罕见病变，占所有肛管鳞状细胞癌的三分之一至四分之一。治疗方法包括对小肿瘤进行手术或单纯放疗，而对较大肿瘤的首选治疗方法是放化疗。在我们科室，选定的SCCAM患者采用一个会阴野的电子束放疗进行治疗。本研究对该策略进行评估。
纳入2012年至2022年期间所有连续接受电子束放疗的SCCAM患者。数据从病历中回顾性提取并进行描述性分析。采用Kaplan-Meier统计分析局部控制（LC）和总生存（OS）情况。
共评估了40例患者。35例（87.5%）患者接受了根治性放疗。5例（12.5%）患者接受了术后放疗。中位处方剂量为60.0（范围45.0 - 60.2）Gy，分28次（范围10 - 30次）给予，使用8（范围4 - 18）MeV的能量，采用标准圆形射野和组织补偿器。中位随访73（范围9 - 135）个月时，7例（17.5%）患者被诊断为局部复发。5年局部控制率为84.3%（95%CI：71.4% - 97.2%）。根据T分期分析局部控制情况，T1期肿瘤的5年局部控制率为100%（95%CI：100% - 100%），而T2期肿瘤为57.0%（95%CI：27.4% - 86.6%）（p < 0.001）。5年总生存率为91.6%（95%CI：83.0% - 100%）。晚期3级毒性包括2例（5.0%）患者出现皮肤和皮下组织溃疡。
电子束放疗能够将“眼引导”放疗直接作用于肿瘤。T1期肿瘤患者的局部控制情况良好。T2期肿瘤患者的局部控制情况不太理想，应采用放化疗进行治疗。电子束放疗能够将“眼引导”放疗直接作用于肿瘤。T1期肿瘤患者的局部控制情况极佳。T2期肿瘤患者的局部控制情况不太理想，应采用放化疗进行治疗。
