Interstitial high-dose rate brachytherapy as boost for anal canal cancer.
OBJECTIVE
To assess clinical outcomes of patients treated with a high-dose rate brachytherapy boost for anal canal cancer (ACC).


METHODS
From August 2005 to February 2013, 28 patients presenting an ACC treated by split-course external beam radiotherapy (EBRT) and HDR brachytherapy with or without chemotherapy in a French regional cancer center in Nice were retrospectively analyzed.


RESULTS
Median age was 60.6 years [34 - 83], 25 patients presented a squamous cell carcinoma and 3 an adenocarcinoma; 21 received chemotherapy. Median dose of EBRT was 45 Gy [43.2 - 52]. Median dose of HDR brachytherapy was 12 Gy [10 - 15] with a median duration of 2 days. Median overall treatment time was 63 days and median delay between EBRT and brachytherapy was 20 days. Two-year local relapse free, metastatic free, disease free and overall survivals were 83%, 81.9%, 71.8% and 87.7% respectively. Acute toxicities were frequent but not severe with mostly grade 1 toxicities: 37% of genito-urinary, 40.7% of gastro-intestinal and 3.7% of cutaneous toxicities. Late toxicities were mainly G1 (43.1%) and G2 (22%). Two-year colostomy-free survival was 75.1%, one patient had a definitive sphincter amputation.


CONCLUSIONS
High-dose rate brachytherapy for anal canal carcinoma as boost represents a feasible technique compared to low or pulsed-dose rate brachytherapy. This technique remains an excellent approach to precisely boost the tumor in reducing the overall treatment time.
Department of Radiation Therapy, Antoine Lacassagne Cancer Center, 33, Avenue de Valombrose, 06189, Nice, Cedex, France. alexander.falk.fr@gmail.com.|University of Nice Sophia-Antipolis, Nice, France. alexander.falk.fr@gmail.com.
Alexander Tuan
AT
Falk
Department of Radiation Therapy, Antoine Lacassagne Cancer Center, 33, Avenue de Valombrose, 06189, Nice, Cedex, France. audreyclaren@hotmail.fr.|University of Nice Sophia-Antipolis, Nice, France. audreyclaren@hotmail.fr.
Audrey
A
Claren
Department of Radiation Therapy, Antoine Lacassagne Cancer Center, 33, Avenue de Valombrose, 06189, Nice, Cedex, France. karen.benezery@nice.unicancer.fr.
Karen
K
Benezery
Departement of Medical Oncology, Antoine Lacassagne Cancer Center, Nice, France. eric.francois@nice.unicancer.fr.
Eric
E
François
Department of Radiation Therapy, Antoine Lacassagne Cancer Center, 33, Avenue de Valombrose, 06189, Nice, Cedex, France. mathieu.gautier@nice.unicancer.fr.
Mathieu
M
Gautier
Department of Radiation Therapy, Antoine Lacassagne Cancer Center, 33, Avenue de Valombrose, 06189, Nice, Cedex, France. jean-pierre.gerard@nice.unicancer.fr.
Jean-Pierre
JP
Gerard
Department of Radiation Therapy, Antoine Lacassagne Cancer Center, 33, Avenue de Valombrose, 06189, Nice, Cedex, France. jean-michel.hannoun-levi@nice.unicancer.fr.|University of Nice Sophia-Antipolis, Nice, France. jean-michel.hannoun-levi@nice.unicancer.fr.
Jean-Michel
JM
Hannoun-Levi
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate