Details

Autor(en) / Beteiligte

• Ortholan, Cécile
• Ramaioli, Alain
• Peiffert, Didier
• Lusinchi, Antoine
• Romestaing, Pascale
• Chauveinc, Laurent
• Touboul, Emmanuel
• Peignaux, Karine
• Bruna, Antoine
• de La Roche, Guy
• Lagrange, Jean-Léon
• Alzieu, Christian
• Gerard, Jean Pierre

Titel

Anal canal carcinoma: Early-stage tumors ≤10 mm (T1 or Tis): Therapeutic options and original pattern of local failure after radiotherapy

Ist Teil von

• International journal of radiation oncology, biology, physics, 2005-06, Vol.62 (2), p.479-485

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2005

Quelle

MEDLINE

Beschreibungen/Notizen

• Purpose: To investigate the clinical history, management, and pattern of recurrence of very early-stage anal canal cancer in a French retrospective survey. Methods: The study group consisted of 69 patients with Stage Tis and T1 anal canal carcinoma ≤1 cm treated between 1990 and 2000 (12 were in situ, 57 invasive, 66 Stage N0, and 3 Stage N1). The median patient age was 67 years (range, 27–83 years). Of the 69 patients, 66 received radiotherapy (RT) and 3 with in situ disease were treated by local excision alone without RT. Twenty-six patients underwent local excision before RT (12 with negative and 14 with positive surgical margins). Of the 66 patients who underwent RT, 8 underwent brachytherapy alone (median dose, 55 Gy), 38 underwent external beam RT (median dose, 45 Gy) plus a brachytherapy boost (median boost dose, 20 Gy), and 20 underwent external beam RT alone (median dose, 55 Gy). Results: Of the 69 patients, 68 had initial local control. Of the 66 patients treated by RT, 6 developed local recurrence at a median interval of 50 months (range, 13–78 months). Four patients developed local failure outside the initial tumor bed. Of the 3 patients with Tis treated by excision alone, 1 developed local recurrence. No relation was found among prior excision, dose, and local failure. The 5-year overall survival, colostomy-free survival, and disease-free survival rate was 94%, 85%, and 89%, respectively. The rate of late complications (Grade 1–3) was 28% and was 14% for those who received doses <60 Gy and 37% for those who received doses of ≥60 Gy ( p = 0.04). Conclusion: Most recurrences occurred after a long disease-free interval after treatment and often outside the initial tumor site. These small anal cancers could be treated by RT using a small volume and moderate dose (40–50 Gy for subclinical lesions and 50–60 Gy for T1).