T1-2 anal carcinoma requires elective inguinal radiation treatment: The results of Trans Tasman Radiation Oncology Group study TROG 99.02

Matthews, John H. L., Burmeister, Bryan H., Borg, Martin, Capp, Anne L., Joseph, David, Thompson, Kerin M., Thompson, Paul I., Harvey, Jennifer A. and Spry, Nigel A. (2011) T1-2 anal carcinoma requires elective inguinal radiation treatment: The results of Trans Tasman Radiation Oncology Group study TROG 99.02. Radiotherapy and Oncology, 98 1: 93-98. doi:10.1016/j.radonc.2010.10.005


Author Matthews, John H. L.
Burmeister, Bryan H.
Borg, Martin
Capp, Anne L.
Joseph, David
Thompson, Kerin M.
Thompson, Paul I.
Harvey, Jennifer A.
Spry, Nigel A.
Title T1-2 anal carcinoma requires elective inguinal radiation treatment: The results of Trans Tasman Radiation Oncology Group study TROG 99.02
Journal name Radiotherapy and Oncology   Check publisher's open access policy
ISSN 0167-8140
1879-0887
Publication date 2011-01
Year available 2010
Sub-type Article (original research)
DOI 10.1016/j.radonc.2010.10.005
Volume 98
Issue 1
Start page 93
End page 98
Total pages 6
Place of publication Brookvale Plaza, E. Park, Shannon, Co. Clare, Ireland
Publisher Elsevier Ireland
Collection year 2012
Language eng
Formatted abstract
Background and purpose: Elective inguinal irradiation increases morbidity. We describe outcomes of moderate intensity chemoradiation treating anal canal and adjacent pelvic nodes only.

Material and methods: Forty patients with T1-2, N0 anal carcinoma were enrolled between March 1999 and March 2003. Inguinal nodes were NOT electively irradiated. The anal canal and regional pelvic nodes received 36 Gy/20# over 4 weeks, and 2 weeks later the anal canal was boosted with 14.4 Gy/8#. Chemotherapy was 5 fluorouracil 800 mg/m2/day on days 1–4 and 36–39, and Mitomycin C 10 mg/m2 on day 1.

Results: Median follow-up was 44 months. Complete response was 95%. Four year results were; overall survival 71%, local control 82%, and colostomy-free survival (including salvage) 85%. Inguinal failure occurred in 22.5% but was isolated in only 12.5%. Treatment was well tolerated acutely with no toxic deaths. Severe late toxicity occurred in 7.5%.

Conclusions: This moderate dose ‘non inguinal’ chemoradiation regimen resulted in modest acute toxicity, minimal long term morbidity and local control in line with other series. However staging failed to identify 12.5% of patients whose isolated inguinal failure might have been prevented by elective irradiation. Without more effective staging, all patients should receive elective inguinal irradiation.
Keyword Anal carcinoma
Inguinal nodes
Chemoradiation therapy
Regional control
External-beam radiotherapy
Squamous-cell carcinoma
Canal carcinoma
Chemoradiation therapy
European-organization
Epidermoid carcinoma
Randomized-trial
Cancer
Fluorouracil
Mitomycin
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 23 November 2010.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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Created: Sun, 06 Mar 2011, 00:02:37 EST