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Chemoradiotherapy with or without consolidation chemotherapy using cisplatin and 5-fluorouracil in anal squamous cell carcinoma: long-term results in 31 patients

Authors
 Byoung Chul Cho  ;  Joong Bae Ahn  ;  Jinsil Seong  ;  Jae Kyung Roh  ;  Joo Hang Kim  ;  Hyun Cheol Chung  ;  Joo Hyuk Sohn  ;  Nam Kyu Kim 
Citation
 BMC CANCER, Vol.8 : 8, 2008 
Journal Title
 BMC CANCER 
Issue Date
2008
MeSH
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Anus Neoplasms/drug therapy* ; Anus Neoplasms/pathology ; Anus Neoplasms/radiotherapy* ; Carcinoma, Squamous Cell/drug therapy* ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/radiotherapy* ; Cisplatin/adverse effects ; Cisplatin/therapeutic use* ; Disease-Free Survival ; Dose-Response Relationship, Drug ; Dose-Response Relationship, Radiation ; Female ; Fluorouracil/adverse effects ; Fluorouracil/therapeutic use* ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Survival Rate ; Time Factors ; Treatment Outcome
Keywords
Anal Cancer ; Radiation Therapy Oncology Group ; Inguinal Lymph Node ; Relative Dose Intensity ; Consolidation Chemotherapy
Abstract
BACKGROUND: The objectives of this study were to evaluate long-term results of concurrent chemoradiotherapy (CRT) with 5-fluorouracil and cisplatin and the potential benefit of consolidation chemotherapy in patients with anal squamous cell carcinoma (ASCC). METHODS: Between January 1995 and February 2006, 31 patients with ASCC were treated with CRT. Radiotherapy was administered at 45 Gy over 5 weeks, followed by a boost of 9 Gy to complete or partial responders. Chemotherapy consisted of 5-fluorouracil (750 or 1,000 mg/m2) daily on days 1 to 5 and days 29 to 33; and, cisplatin (75 or 100 mg/m2) on day 2 and day 30. Twelve patients had T3-4 disease, whereas 18 patients presented with lymphadenopathy. Twenty-one (67.7%) received consolidation chemotherapy with the same doses of 5-fluorouracil and cisplatin, repeated every 4 weeks for maximum 4 cycles. RESULTS: Nineteen patients (90.5%) completed all four courses of consolidation chemotherapy. After CRT, 28 patients showed complete responses, while 3 showed partial responses. After a median follow-up period of 72 months, the 5-year overall, disease-free, and colostomy-free survival rates were 84.7%, 82.9% and 96.6%, demonstrating that CRT with 5-fluorouracil and cisplatin yields a good outcome in terms of survival and sphincter preservation. No differences in 5-year OS and DFS rates between patients treated with CRT alone and CRT with consolidation chemotherapy was observed. CONCLUSION: our study shows that CRT with 5-FU and cisplatin, with or without consolidation chemotherapy, was well tolerated and proved highly encouraging in terms of long-term survival and the preservation of anal function in ASCC. Further trials with a larger patient population are warranted in order to evaluate the potential role of consolidation chemotherapy
Files in This Item:
T200800207.pdf Download
DOI
10.1186/1471-2407-8-8
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Kim, Joo Hang(김주항)
Roh, Jae Kyung(노재경)
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Sohn, Joo Hyuk(손주혁) ORCID logo https://orcid.org/0000-0002-2303-2764
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Cho, Byoung Chul(조병철) ORCID logo https://orcid.org/0000-0002-5562-270X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/106349
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