Concurrent chemoradiotherapy for men with locally advanced penile squamous cell carcinoma.
BACKGROUND
Outcomes with concurrent chemoradiotherapy for penile squamous cell carcinoma (PSCC) are unclear, and only anecdotal reports have been published. This study was a retrospective analysis of patients who received concurrent chemotherapy and radiotherapy for PSCC.


METHODS
Individual patient-level data were obtained from 5 institutions for outcomes with concurrent chemoradiotherapy for PSCC. Descriptive statistics were calculated, and univariable Cox proportional hazards regression analysis was conducted to examine the prognostic effect of candidate factors on progression-free survival (PFS) and overall survival (OS).


RESULTS
A total of 26 men were evaluable. The mean age was 60.3 years. The clinical stage was ≤ III in 9 patients (36%) and stage IV in the rest. Soft tissue and visceral metastasis were present in 35% and 20% of patients, respectively. The chemotherapy was cisplatin-based in 92.3% of patients, and the median (range) of external beam radiotherapy administered was 4900 cGy (range, 1800-7000 cGy). The median OS was 6.9 months (95% CI, 5-14), and the median PFS was 5.1 months (95% CI, 2.5-7.0). When excluding patients with M1 disease, the remaining patients (n = 21) had a median OS and PFS of 10.0 months (95% CI, 5-14) and 6.0 months (95% CI, 2.0-7.0), respectively. Baseline neutrophil to lymphocyte ratio (NLR) was significantly associated with survival, and visceral metastasis showed a trend for association with OS.


CONCLUSIONS
Concurrent chemoradiotherapy demonstrated poor outcomes for locally advanced PSCC. Better understanding of tumor biology and study of novel combinations of biologic agents with radiation are warranted.
McMaster University, Hamilton, Ontario, Canada.
Gregory R
GR
Pond
University of North Carolina, Chapel Hill, NC.
Matthew I
MI
Milowsky
University of Alberta, Edmonton, Alberta, Canada.
Michael P
MP
Kolinsky
BC Cancer Agency, Vancouver, British Columbia, Canada.
Bernhard J
BJ
Eigl
Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
Andrea
A
Necchi
Dana-Farber Cancer Institute, Boston, MA.
Lauren C
LC
Harshman
University Federico II, Napoli, Italy.
Giuseppe
G
Di Lorenzo
University of Southern California, CA.
Tanya B
TB
Dorff
Massachusetts General Hospital Cancer Center, Boston, MA.
Richard J
RJ
Lee
University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham, AL. Electronic address: gsonpavde@uabmc.edu.
Guru
G
Sonpavde
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D059248:Chemoradiotherapy / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010412:Penile Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D016016:Proportional Hazards Models; D012189:Retrospective Studies
Chemoradiation; Locally advanced; Outcomes; Penile squamous cell carcinoma; Prognosis