title: [Should the treatment of anal carcinoma be adapted in the elderly? A retrospective analysis of acute toxicities in a French centre and a review of the literature].
abstract: OBJECTIVE
  To study the tolerance to radiotherapy, with or without chemotherapy, followed by brachytherapy, in elderly patients (75 years or older) suffering from anal cancer.
  
  
  METHODS
  We treated 12 elderly patients with a curative intent. Median age was 78 years (range: 75-90). Ten patients had a stage II or IIIA (UICC 2009) tumour and six out of 12 were N+. Taking into account the age, the Eastern Cooperative Oncology Group (ECOG) performance status and comorbidities, five patients received exclusive radiotherapy ("RT group") and seven a concomitant radiochemotherapy ("RT-CT group"). All patients received a boost by interstitial brachytherapy. One patient of the "RT-CT group" presented rectorragies during brachytherapy. The irradiation was completed by external beam radiotherapy focalized on the tumour volume.
  
  
  RESULTS
  Grade 3 acute reactions (Radiation Therapy Oncology Group [RTOG]) were reported in three out of 12 patients. One grade 2-3 leucopoenia was observed in one out of 7 patients ("RT-CT group"). After brachytherapy, one grade 3 rectal toxicity (rectorragia) (in "RT group") and one grade 4 (in "RT-CT group") were observed. One patient ("RT-CT group") presented a late grade 3 rectal toxicity (evaluated only for patients with at least 12 months of follow-up).
  
  
  CONCLUSIONS
  Concomitant radiochemotherapy followed by brachytherapy showed an acceptable toxicity profile, and seems to be adapted in selected elderly patients. It could be recommended as reference treatment in elderly patients with a good physiological status.
authors.affiliation: Département de radiothérapie oncologie, centre hospitalier Lyon-Sud, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France. bdebari@yahoo.it
authors.forename: B
authors.initials: B
authors.lastname: De Bari
authors.forename: L
authors.initials: L
authors.lastname: Lestrade
authors.forename: T
authors.initials: T
authors.lastname: Chekrine
authors.forename: I
authors.initials: I
authors.lastname: Shakir Shakir
authors.forename: J-M
authors.initials: JM
authors.lastname: Ardiet
authors.forename: O
authors.initials: O
authors.lastname: Chapet
authors.forename: F
authors.initials: F
authors.lastname: Mornex
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001005:Anus Neoplasms / Q000473:pathology / Q000628:therapy*; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D019583:Dose Fractionation, Radiation; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005602:France; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007970:Leukopenia / Q000209:etiology; D008297:Male; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies
chemical_list: D002945:Cisplatin; D005472:Fluorouracil