Treatment of squamous cell anal canal carcinoma (SCACC) with pulsed dose rate brachytherapy: a retrospective study.
OBJECTIVE
To evaluate the results of pulsed dose rate brachytherapy (PDR) in SCACC.


METHODS
From 1996 to 2002, 71 patients (pts) with SCACC were treated with PDR brachytherapy. The median age was 61.2 years (35-88), with a sex ratio of 1 M/6.5 F. The TNM classification was: 14 T1, 41 T2, 15 T3 and 1 T4, 52 N0, 13 N1, 3 N2 and 3 N3. All the pts were M0. Treatment started with external beam irradiation to the posterior pelvis (mean dose: 45.5 Gy). Forty-seven patients received chemotherapy (neoadjuvant/concomitant or both). After an interval of 2-6 weeks, PDR interstitial brachytherapy was performed. The mean dose was 17.8 Gy to the 85% reference isodose of the Paris system.


RESULTS
Treatment was interrupted in only one pt. With a median follow-up of 28.5 months, 2-year actuarial overall survival was 90%. Fourteen relapses occurred (four distant, three regional, and seven local). Ten patients developed a grade III complication (Lent Soma scale) and two a grade IV complication (colostomy or abdominal perineal resection for necrosis).


CONCLUSIONS
PDR appears to be an effective treatment for SCACC. It is capable of reproducing the results usually observed with continuous LDR.
Bruna
Antoine
A
Brachytherapy Department, Centre Alexis Vautrin, Vandoeuvre Lès Nancy, France. bruna@igr.fr
Gastelblum
Pauline
P
Thomas
Laurence
L
Chapet
Olivier
O
Bollet
Marc A
MA
Ardiet
Jean-Michel
JM
Gérard
Jean-Pierre
JP
Peiffert
Didier
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001005:Anus Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D001918:Brachytherapy / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome