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Chemoradiotherapy for Squamous Cell Carcinoma of Anal Canal

By: Hillary Ojeda
Posted: Thursday, January 3, 2019

A retrospective review showed that extended-field chemoradiation may be potentially curative treatment for patients with squamous cell carcinoma of the anal canal with metastases of the para-aortic lymph nodes. Emma B. Holliday, MD, of The University of Texas Anderson Cancer Center, and colleagues published their findings in the International Journal of Radiation Oncology.

“Although involvement of the para-aortic nodes is considered metastatic disease for squamous cell carcinoma of the anal canal, we have long suspected that these patients do not have the poor prognosis that accompanies a stage IV diagnosis in other cancers,” stated Dr. Holliday in an American Society for Radiation Oncology (ASTRO) press release. “The results from this study showed that aggressive combination treatment with definitive extended-field chemoradiation can lead to good outcomes.”

The researchers reviewed the data on 30 patients with squamous cell carcinoma of the anal canal metastatic to the para-aortic lymph nodes. These patients were treated with chemoradiation therapy between September 2002 and February 2016 and then received radiation treatments of 51 Gy and 45 Gy in 29 fractions. The chemotherapy treatment included either six weekly cycles of cisplatin with 5-fluorouracil (5-FU)/capecitabine, two cycles of mitomycin-C with 5-FU, or daily capecitabine.

With 3.1 years of follow-up, 18 of 30 patients were alive, and 17 indicated no signs of anal cancer. The patients’ overall survival rate was 67%, and their disease-free survival rate was 42%. Half of the patients experienced recurrence, primarily seen as distant metastases. Some of the patients experienced grade 3 or 4 gastrointestinal (30%), dermatologic (27%), and hematologic (20%) adverse events.

“If we can deliver a curative dose of radiation to all sites of disease, we have the potential to extend survival for these patients,” noted Dr. Holliday in the ASTRO press release.

Disclosure: Study authors’ disclosure information may be found at International Journal of Radiation Oncology.



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