1. Comparing simultaneous integrated boost vs sequential boost in anal cancer patients: results of a retrospective observational study
- Author
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Manuela Ceccarelli, Giuseppe Carlo Iorio, Massimiliano Mistrangelo, Francesca Arcadipane, Umberto Ricardi, Pierfrancesco Franco, G. Furfaro, Alessandro Passardi, Alexis Lepinoy, Berardino De Bari, Stefania Martini, Andrea Casadei Gardini, Martina Valgiusti, Gilles Créhange, Elisabetta Trino, Andrea Evangelista, Paola Cassoni, Oncologia Medica, Dipartimento di Scienze Cliniche e Biologiche Università di Torino, Azienda Ospedaliera Universitaria San Luigi di Orbassano, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Paul Strauss de Lutte contre le Cancer (Strasbourg), University of Torino and CPO-Piemonte, Università degli studi di Torino (UNITO), Department of Pathology, Università degli studi di Torino (UNITO)-San Luigi Hospital, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (Meldola), Istituto Nazionale per la Ricerca sul Cancro, Genova, Immunologia, Department of Oncology [University of Turin], University of Turin, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Département de Radiation oncologie, CGFL, UNICANCER-UNICANCER, Franco, Pierfrancesco, De Bari, Berardino, Arcadipane, Francesca, Lepinoy, Alexi, Ceccarelli, Manuela, Furfaro, Gabriella, Mistrangelo, Massimiliano, Cassoni, Paola, Valgiusti, Martina, Passardi, Alessandro, Casadei Gardini, Andrea, Trino, Elisabetta, Martini, Stefania, Iorio, Giuseppe Carlo, Evangelista, Andrea, Ricardi, Umberto, and Créhange, Gilles
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Oncology ,Male ,Local-Control ,Squamous-Cell Carcinoma ,Treatment Time ,[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging ,medicine.medical_treatment ,Concurrent Chemotherapy ,European Organization ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,Antineoplastic Combined Chemotherapy Protocols ,Simultaneous integrated boost ,Cumulative incidence ,Hazard ratio ,Chemoradiotherapy ,Middle Aged ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Anus Neoplasms ,Primary tumor ,3. Good health ,Italy ,030220 oncology & carcinogenesis ,Mitomycin-C ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Female ,Fluorouracil ,France ,Overall treatment time ,medicine.drug ,lcsh:Medical physics. Medical radiology. Nuclear medicine ,Gastrointestinal Cooperative Groups ,medicine.medical_specialty ,lcsh:R895-920 ,Mitomycin ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,[SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine ,lcsh:RC254-282 ,Capecitabine ,03 medical and health sciences ,Median follow-up ,Internal medicine ,medicine ,Anal cancer ,Modulated Radiation-Therapy ,Humans ,Radiology, Nuclear Medicine and imaging ,Concomitant radio-chemotherapy ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Radiotherapy ,business.industry ,Research ,Retrospective cohort study ,Epidermoid Carcinoma ,Anal cancer radiotherapy ,medicine.disease ,Radiation therapy ,Sequential boost ,Anal cancer radiotherapy, Concomitant radio-chemotherapy, Simultaneous integrated boost, Sequential boost, Overall treatment time ,Radiotherapy, Intensity-Modulated ,business - Abstract
International audience; BackgroundTo evaluate clinical outcomes of simultaneous integrated boost (SIB) - intensity modulated radiotherapy (RT) in patients with non metastatic anal cancer compared to those of a set of patients treated with 3-dimensional conformal RT and sequential boost (SeqB).MethodsA retrospective cohort of 190 anal cancer patients treated at 3 academic centers with concurrent chemo-RT employing either SIB or SeqB was analysed. The SIB-group consisted of 87 patients, treated with 2 cycles of Mitomycin (MMC) and 5-Fluorouracil (5FU) using SIB-IMRT delivering 42-45Gy/28–30 fractions to the elective pelvic lymph nodes and 50.4-54Gy/28-30fractions to the primary tumor and involved nodes, based on pre-treatment staging. The SeqB group comprised 103 patients, treated with MMC associated to either 5FU or Capecitabine concurrent to RT with 36 Gy/20 fractions to a single volume including gross tumor, clinical nodes and elective nodal volumes and a SeqB to primary tumor and involved nodes of 23.4 Gy/13 fractions. We compared colostomy-free survival (CFS), overall survival (OS) and the cumulative incidence of colostomy for each radiation modality. Cox proportional-hazards model addressed factors influencing OS and CFS.ResultsMedian follow up was 34 (range 9–102) and 31 months (range 2–101) in the SIB and SeqB groups. The 1- and 2-year cumulative incidences of colostomy were 8.2% (95%CI:3.6–15.2) and 15.0% (95%CI:8.1–23.9) in the SIB group and 13.9% (95%CI: 7.8–21.8) and 18.1% (95%CI:10.8–27.0) in the SeqB group. Two-year CFS and OS were 78.1% (95%CI:67.0–85.8) and 87.5% (95%CI:77.3–93.3) in the SIB group and 73.5% (95%CI:62.6–81.7) and 85.4% (95%CI:75.5–91.6) in the SeqB, respectively. A Cox proportional hazards regression model highlighted an adjusted hazard ratio (AdjHR) of 1.18 (95%CI: 0.67–2.09;p = 0.560), although AdjHR for the first 24 months was 0.95 (95%CI: 0.49–1.84;p = 0.877) for the SIB approach.ConclusionsSIB-based RT provides similar clinical outcomes compared to SeqB-based in the treatment of patients affected with non metastatic anal cancer.
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- 2018
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