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Selected Publication:
Kapp, KS; Geyer, E; Gebhart, FH; Oechs, AC; Berger, A; Hebenstreit, J; Stoeger, H.
Experience with split-course external beam irradiation +/- chemotherapy and integrated Ir-192 high-dose-rate brachytherapy in the treatment of primary carcinomas of the anal canal.
Int J Radiat Oncol Biol Phys. 2001; 49(4):997-1005
Doi: 10.1016/s0360-3016(00)01427-9
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- Leading authors Med Uni Graz
- Kapp Karin S.
- Co-authors Med Uni Graz
- Stöger Herbert
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- Abstract:
- The effect of the treatment of anal cancer by performing a high-dose-rate (HDR) brachytherapy boost during a short split between the external beam radiotherapy series (EBR) +/- chemotherapy was investigated. Thirty-nine patients with anal canal cancers, stages T1-T4 N0-2 M0, were treated with split-course EBR (50-50.4 Gy) and a Iridium 192 ((192)Ir-) HDR boost (6 Gy) performed during the 1-2-week split. Patients who failed to achieve a complete tumor response received additional brachytherapy. Chemotherapy with 5-fluorouracil and mitomycin C was offered to patients with tumors > 3 cm and employed concomitantly on days 1-5 and day 1, respectively, of each EBR series. Follow-up ranged from 3 to 140 months (median 31). Median treatment duration was 56 days. The 3-year (5-year) actuarial rates of locoregional control (LRC) and disease-specific survival (DSS) were 81% (76%) and 80% (76%), respectively. The crude rate of anal preservation was 77% overall, and 97% in patients in whom LRC was achieved. Uncompromised anal function was recorded in 93% of these patients. The actuarial 3-year (5-year) rate of colostomy-free survival (CFS) was 78% (73%). There was a statistically significant difference in LRC and DSS according to stage, tumor size, and nodal status. Complications requiring surgical intervention occurred in 7.6% of patients. The integration of the HDR boost in a split-course EBR regimen +/- chemotherapy resulted in excellent sphincter function without an increase of severe complications and with rates of LRC, DSS, and CFS, which compare favorably with those reported in the literature.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Aged, 80 and over -
- Antineoplastic Combined Chemotherapy Protocols - adverse effects
- Antineoplastic Combined Chemotherapy Protocols - therapeutic use
- Anus Neoplasms - drug therapy
- Anus Neoplasms - pathology
- Anus Neoplasms - radiotherapy
- Brachytherapy - adverse effects
- Brachytherapy - methods
- Carcinoma, Squamous Cell - drug therapy
- Carcinoma, Squamous Cell - pathology
- Carcinoma, Squamous Cell - radiotherapy
- Combined Modality Therapy -
- Disease-Free Survival -
- Female -
- Fluorouracil - administration & dosage
- Follow-Up Studies -
- Humans -
- Iridium Radioisotopes - therapeutic use
- Male -
- Middle Aged -
- Mitomycin - administration & dosage
- Neoplasm Staging -
- Radiotherapy Dosage -
- Retrospective Studies -
- Treatment Failure -
- Find related publications in this database (Keywords)
- anal cancer
- external beam irradiation
- chemotherapy
- high-dose-rate brachytherapy
- sphincter function