title: Radiation dose associated with local control in advanced anal cancer: retrospective analysis of 129 patients.
abstract: OBJECTIVE
  To retrospectively analyse a large consecutive cohort of patients with anal cancer for treatment-related factors influencing local control and survival.
  
  
  METHODS
  All patients referred for primary radiotherapy at Medical University of Vienna in 1990-2002 with anal canal carcinoma without distant metastases were analysed. Treatment consisted of external radiotherapy with or without brachytherapy and with or without chemotherapy. Patient-, tumour-, and treatment-factors were tested for influence on survival and local control using Cox multivariate analysis.
  
  
  RESULTS
  Median age was 67 years (n=129), the UICC stage distribution was 15%, 58%, and 27% for stages I, II, and III, respectively. With median follow-up of 8.0 years for surviving patients (3.9 years including deceased patients), five-year overall survival and disease-free-survival were 57% and 51%, respectively. Local control at 5 years was 87%. Stage and age were significant factors for overall and colostomy-free-survival, N-stage for disease-free-survival. Shorter overall treatment time favoured local control in stage T1-2 (p=.015), higher total radiation dose and female gender were associated with improved local control in T3-4 tumours (p=.021).
  
  
  CONCLUSIONS
  These results support potential improvement of anal cancer treatment by studying advanced technology such as IMRT, making it possible to tailor high-dose regions.
authors.affiliation: Department of Radiotherapy, Medical University of Vienna, Austria. j.widder@rt.umcg.nl
authors.forename: Joachim
authors.initials: J
authors.lastname: Widder
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kastenberger
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Fercher
authors.forename: Rainer
authors.initials: R
authors.lastname: Schmid
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Langendijk
authors.forename: Werner
authors.initials: W
authors.lastname: Dobrowsky
authors.forename: Richard
authors.initials: R
authors.lastname: Pötter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011879:Radiotherapy Dosage; D015996:Survival Rate