ICT And Dose Intensification Of The Radiation Boost In Locally Advanced Anal Canal Carcinoma

Main Category: Radiology / Nuclear Medicine
Also Included In: Colorectal Cancer;  Cancer / Oncology;  GastroIntestinal / Gastroenterology
Article Date: 22 Sep 2008 - 3:00 PDT

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Anal cancer is rare but the incidence is increasing, associated with HPV infection. Cure is possible in the majority of patients with the preservation of the anus and a functional anal sphincter. Abdominoperineal resection is reserved for patients with local relapse or late complications.

For locally advanced disease, a concomitant chemotherapy improved the functional results and the rate of colostomy-free survival as well as local control, but failure was observed in 25% of the patients.

A dose intensification of the treatment was studied in this prospective phase IIItrial with 307 patients included. The aim of the study was to assess the benefit on the colostomy - free survival of two cycles of induction chemotherapy (5 FU + CDDP) and an increase of the dose of irradiation delivered to the primary, from 60 to 65-70 Gy.

The tolerance was good. The results, after a mean follow-up of 3 years, showed an 88% local control rate but did not show any benefit of the intensification group compared to standard treatment in a 2X2 factorial analysis.

Further analysis will be conducted to identify a subgroup of patients who potentially benefit of intensification.

Peiffert Didier et al. Centre Alexis Vautrin, Vandoeuvre-lès-Nancy, France

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