ISSN:
1569-8041
Keywords:
anal cancer
;
cisplatin
;
5-fluorouracil
;
phase II study
;
radiation therapy
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background: Chemotherapy (5-fluorouracil–mitomycin C) concomitant withradiotherapy (RT) increases local control and colostomy-free survival inadvanced anal canalcarcinomas (ACC). The purpose of this prospective trial was to analyse thetoxicity of and response to an induction chemotherapy combining 5-fluorouracil(5-FU) and CDDP administered concomitantly with irradiation. Patients and methods: Thirty patients (24 F/6 M, mean age 60, range38–74) with an advanced ACC 〉40 mm and/or with node involvement wereprospectively treated (1 T1, 16 T2, 8 T3, 5 T4, 10 N1, 1 N2, 8 N3) fromNovember 1994 to January 1996. Two induction and two concomitant cycles of5-FU(800 mg/m2 D1–4 infusion) and CDDP (80mg/i.v./m2 at D1) were delivered. RT consisted of 45 Gy (1.8Gy/fr, 5 fr/w) on pelvis ± inguinal nodes or 30 Gy (3 Gy/fr, 4 fr/w)by direct perineal field. A boost (15–20 Gy) was delivered six weekslater. Results: Toxicity: one patient died of a pulmonary embolism on D4.The remaining 29 received the entire treatment, with reduced 5-FU doses in 11patients because of acute toxicity. The RT boost was delayed for one patient(aplasia). In 109 cycles, 3 grade 4 and 17 grade 3 toxicities were observed;there were no toxic deaths. Tumor response: the complete response (CR)and partial response (PR) rates were, respectively, 11% and 61%after induction chemotherapy, 59% and 31% after concomitantradiochemotherapy and 96% and 0% two months after completion ofthe treatment. No tumor progression was observed. Conclusion: the treatment was well tolerated and there was good compliance.After induction chemotherapy, most of the patients were in PR, with some evenin CR. After completion of the treatment all but one were in CR. The tumorresponse and the long term results of 50 patients will be analysed beforeinitiation of a randomised trial is considered.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008295119573
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