Long-term oncologic and complication outcomes in anal cancer patients treated with radiation therapy
Ji Hyeon Joo1, Jin-hong Park2, Sang Min Yoon2, Jin Cheon Kim3, Chang Sik Yu3, Tae Won Kim4, Jong Hoon Kim2
1 Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Department of Radiation Oncology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
2 Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
3 Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
4 Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Jong Hoon Kim
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505
Source of Support: None, Conflict of Interest: None
Aim: The aim of the study is to analyze prognostic factors for tumor control, survival, and late toxicity in patients with anal cancer treated with chemoradiation.
Materials and Methods: Anal cancer patients treated between 1996 and 2010 were analyzed. Patients received radiotherapy and concurrent 5-fluorouracil and mitomycin-C.
Results: Data from 70 patients were analyzed. With a median follow-up of 6.4 years, 5-year overall survival and progression-free survival were 88% and 84%, respectively. Female gender and total radiation dose (≥54 Gy) were significantly associated with better local control. For survival, female gender, patient age, and tumor size were significant prognostic factors. The most common late toxicity was lymphedema. Possible prognosticators were examined, and only radiation dose to the inguinal area was significant.
Conclusion: Despite moderately high radiation doses, local recurrence, and late complications were problems in treating anal cancer. In the intensity-modulated radiotherapy era, consensus on accurate target volume based on the pattern of failure analysis is required.