Long-term results of weekly/daily cisplatin-based chemoradiation for locally advanced squamous cell carcinoma of the anal canal
Article first published online: 20 AUG 2013
© 2013 American Cancer Society
Volume 119, Issue 21, pages 3769–3775, 1 November 2013
How to Cite
Eng, C., Chang, G. J., You, Y. N., Das, P., Xing, Y., Delclos, M., Wolff, R. A., Rodriguez-Bigas, M. A., Skibber, J., Ohinata, A., Gould, S., Phillips, J. and Crane, C. H. (2013), Long-term results of weekly/daily cisplatin-based chemoradiation for locally advanced squamous cell carcinoma of the anal canal. Cancer, 119: 3769–3775. doi: 10.1002/cncr.28296
- Issue published online: 18 OCT 2013
- Article first published online: 20 AUG 2013
- Manuscript Accepted: 9 JUL 2013
- Manuscript Revised: 1 JUL 2013
- Manuscript Received: 2 MAY 2013
- combined therapy;
- anal carcinoma;
Weekly or daily cisplatin and 5-fluorouracil (5-FU)-based chemoradiation was evaluated for patients with locally advanced squamous cell carcinoma (SCC) of the anal canal treated at a single institution over a 20-year period.
A retrospective, single-institution analysis was conducted of patients receiving concurrent 5-FU/cisplatin and radiotherapy for locally advanced SCC from 1989 to 2009. Endpoints included clinical complete response rate, local recurrence rate, colostomy-free survival, disease-free survival (DFS), overall survival, and treatment-related toxicity.
A total of 197 patients were evaluable. The majority had American Joint Committee on Cancer stage II (41%) or stage III (46%) disease; most were T2 (44%) or T3 (27%); bulky nodal disease (N2-N3) was noted in 24% of patients. Patients received weekly (20 mg/m2) or daily (4 mg/m2) cisplatin during radiotherapy. Median radiation dose was 55 Gy. Clinical complete response was observed in 185 patients (94%). After a median follow-up of 8.6 years, local recurrence rate was 11%. Sixteen patients (8%) developed distant metastases. The 5-year DFS was 81%, the 5-year overall survival was 86%, and the 5-year colostomy-free survival was 88%. By univariate analysis, N-stage was a poor prognostic indicator for 5-year DFS (P = .02, 95% confidence interval = 1.17-2.01) and distant metastases (P = .046, 95% confidence interval = 1.09-2.13). Increased T-stage correlated with the necessity for salvage surgery (P = .01).
The combination of weekly/daily cisplatin and 5-FU–based chemotherapy with concurrent radiotherapy is an effective regimen, and our long-term results indicate that cisplatin is an alternative to mitomycin C and may be considered for the treatment of locally advanced SCC of the anal canal. Cancer 2013;119:3769–3775. © 2013 American Cancer Society.