Intensity-Modulated Radiotherapy for Squamous Cell Carcinoma of the Anal Canal: Efficacy of a Low Daily Dose to Clinically Negative Regions

Jason A. Call, Michael Haddock, J. Fernando Quevedo, David Larson, Robert C. Miller

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Abstract

Background: We aimed to assess outcomes of patients with anal cancer who underwent intensity-modulated radiotherapy (IMRT) and received less than 1.80 Gy/day. Methods: We retrospectively reviewed our experience using a low fractional dose (less than 1.80 Gy) of IMRT to elective nodal areas for patients receiving chemoradiotherapy for anal cancer. Three-year freedom from any disease relapse and overall survival were estimated using Kaplan-Meier curves. We documented the daily dose that was delivered to clinically uninvolved regions and to areas of gross disease. Incidence of regional failures in high (greater than or equal to 1.80 Gy) and low (less than 1.80 Gy) daily dose regions was assessed. Results: Thirty-four consecutive patients (median age, 59 years) received IMRT from June 2005 through January 2009. Median follow-up duration was 22 months. Twenty-eight patients had T1 or T2 disease and 6 had T3 or T4 disease. Fourteen patients had nodal metastases. Median treatment dose was 50.40 Gy (range, 48.60-57.60 Gy) in 25 to 32 fractions. The range of fractional doses to clinically negative volumes was 1.28 to 1.80 Gy. Seventeen patients (50%) received a fractional dose of less than 1.60 Gy, 13 (38%) received less than 1.50 Gy, and 9 (26%) received less than 1.40 Gy to at least a portion of the clinically negative volume. Three-year freedom from relapse was 80%, and 3-year overall survival was 87%. No patient had treatment failure in the clinically negative volume that received a low daily dose. Conclusions: Our data support using doses between 1.50 and 1.80 Gy/day to clinically uninvolved regions.

Original languageEnglish (US)
Pages (from-to)134
Number of pages1
JournalRadiation Oncology
DOIs
StateAccepted/In press - Oct 6 2011

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Intensity-Modulated Radiotherapy
Anal Canal
Squamous Cell Carcinoma
Anus Neoplasms
Recurrence
Survival
Chemoradiotherapy
Treatment Failure
Neoplasm Metastasis
Incidence

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Oncology
  • Medicine(all)

Cite this

Intensity-Modulated Radiotherapy for Squamous Cell Carcinoma of the Anal Canal : Efficacy of a Low Daily Dose to Clinically Negative Regions. / Call, Jason A.; Haddock, Michael; Quevedo, J. Fernando; Larson, David; Miller, Robert C.

In: Radiation Oncology, 06.10.2011, p. 134.

Research output: Contribution to journalArticle

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abstract = "Background: We aimed to assess outcomes of patients with anal cancer who underwent intensity-modulated radiotherapy (IMRT) and received less than 1.80 Gy/day. Methods: We retrospectively reviewed our experience using a low fractional dose (less than 1.80 Gy) of IMRT to elective nodal areas for patients receiving chemoradiotherapy for anal cancer. Three-year freedom from any disease relapse and overall survival were estimated using Kaplan-Meier curves. We documented the daily dose that was delivered to clinically uninvolved regions and to areas of gross disease. Incidence of regional failures in high (greater than or equal to 1.80 Gy) and low (less than 1.80 Gy) daily dose regions was assessed. Results: Thirty-four consecutive patients (median age, 59 years) received IMRT from June 2005 through January 2009. Median follow-up duration was 22 months. Twenty-eight patients had T1 or T2 disease and 6 had T3 or T4 disease. Fourteen patients had nodal metastases. Median treatment dose was 50.40 Gy (range, 48.60-57.60 Gy) in 25 to 32 fractions. The range of fractional doses to clinically negative volumes was 1.28 to 1.80 Gy. Seventeen patients (50{\%}) received a fractional dose of less than 1.60 Gy, 13 (38{\%}) received less than 1.50 Gy, and 9 (26{\%}) received less than 1.40 Gy to at least a portion of the clinically negative volume. Three-year freedom from relapse was 80{\%}, and 3-year overall survival was 87{\%}. No patient had treatment failure in the clinically negative volume that received a low daily dose. Conclusions: Our data support using doses between 1.50 and 1.80 Gy/day to clinically uninvolved regions.",
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AU - Larson, David

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N2 - Background: We aimed to assess outcomes of patients with anal cancer who underwent intensity-modulated radiotherapy (IMRT) and received less than 1.80 Gy/day. Methods: We retrospectively reviewed our experience using a low fractional dose (less than 1.80 Gy) of IMRT to elective nodal areas for patients receiving chemoradiotherapy for anal cancer. Three-year freedom from any disease relapse and overall survival were estimated using Kaplan-Meier curves. We documented the daily dose that was delivered to clinically uninvolved regions and to areas of gross disease. Incidence of regional failures in high (greater than or equal to 1.80 Gy) and low (less than 1.80 Gy) daily dose regions was assessed. Results: Thirty-four consecutive patients (median age, 59 years) received IMRT from June 2005 through January 2009. Median follow-up duration was 22 months. Twenty-eight patients had T1 or T2 disease and 6 had T3 or T4 disease. Fourteen patients had nodal metastases. Median treatment dose was 50.40 Gy (range, 48.60-57.60 Gy) in 25 to 32 fractions. The range of fractional doses to clinically negative volumes was 1.28 to 1.80 Gy. Seventeen patients (50%) received a fractional dose of less than 1.60 Gy, 13 (38%) received less than 1.50 Gy, and 9 (26%) received less than 1.40 Gy to at least a portion of the clinically negative volume. Three-year freedom from relapse was 80%, and 3-year overall survival was 87%. No patient had treatment failure in the clinically negative volume that received a low daily dose. Conclusions: Our data support using doses between 1.50 and 1.80 Gy/day to clinically uninvolved regions.

AB - Background: We aimed to assess outcomes of patients with anal cancer who underwent intensity-modulated radiotherapy (IMRT) and received less than 1.80 Gy/day. Methods: We retrospectively reviewed our experience using a low fractional dose (less than 1.80 Gy) of IMRT to elective nodal areas for patients receiving chemoradiotherapy for anal cancer. Three-year freedom from any disease relapse and overall survival were estimated using Kaplan-Meier curves. We documented the daily dose that was delivered to clinically uninvolved regions and to areas of gross disease. Incidence of regional failures in high (greater than or equal to 1.80 Gy) and low (less than 1.80 Gy) daily dose regions was assessed. Results: Thirty-four consecutive patients (median age, 59 years) received IMRT from June 2005 through January 2009. Median follow-up duration was 22 months. Twenty-eight patients had T1 or T2 disease and 6 had T3 or T4 disease. Fourteen patients had nodal metastases. Median treatment dose was 50.40 Gy (range, 48.60-57.60 Gy) in 25 to 32 fractions. The range of fractional doses to clinically negative volumes was 1.28 to 1.80 Gy. Seventeen patients (50%) received a fractional dose of less than 1.60 Gy, 13 (38%) received less than 1.50 Gy, and 9 (26%) received less than 1.40 Gy to at least a portion of the clinically negative volume. Three-year freedom from relapse was 80%, and 3-year overall survival was 87%. No patient had treatment failure in the clinically negative volume that received a low daily dose. Conclusions: Our data support using doses between 1.50 and 1.80 Gy/day to clinically uninvolved regions.

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