Anal cancer treated with radio-chemotherapy: correlation between length of treatment interruption and outcome

• Published in: International journal of colorectal disease 2009-12, Vol.24 (12), p.1421-1428
• Main Authors: Janssen, Stefan, Meier zu Eissen, Jürgen, Kolbert, Gerd, Bremer, Michael, Karstens, Johann Hinrich, Meyer, Andreas
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Anus Neoplasms - drug therapy; Anus Neoplasms - radiotherapy; Biological and medical sciences; Female; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Hepatology; Humans; Internal Medicine; Kaplan-Meier Estimate; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Original Article; Proctology; Radiotherapy - adverse effects; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery; Time Factors; Treatment Outcome; Tumors
• ISSN: 0179-1958; 1432-1262
• DOI: 10.1007/s00384-009-0775-2

Aim The purpose of this study was the evaluation of the feasibility and outcome of definitive radio-chemotherapy without split-course technique but with individualised short treatment interruption in anal cancer patients. Method Between 1993 and 2008, 101 patients with anal cancer were treated in our institution with definitive radio-chemotherapy with individualised short treatment interruptions. Treatment was halted independent of dose in case of acute grade 3 toxicities and started again until improvement. Short interruption was defined as completing treatment without exceeding six cumulative treatment days beyond a scheduled plan; otherwise, it was defined as prolonged interruption. Results Median overall treatment time was 47 days corresponding to an interruption of six cumulative treatment days. Fifty-one patients (50%) had treatment interruption of ≤6 days. No acute grade 4 toxicities were observed. One fatality occurred during treatment due to ileus-like symptoms according to acute grade 5 toxicity. After a median follow-up of 56 months, the 5-year actuarial rates for local control comparing patients with short vs. prolonged treatment interruption were 78% vs. 81% (p = 0.904) and, for colostomy-free survival, 83% vs. 85% (p = 0.784), respectively. Conclusions Definitive radio-chemotherapy with short individualised treatment interruption shows high local control and colostomy-free survival rates.