논문검색
Author Kyoung-Ju Kim, M.D.1, Jong-Hoon Kim, M.D.1, Eun-Kyung Choi, M.D.1, Seung-Do Ahn, M.D.1, Sang- Wook Lee, M.D.1, Jin-Cheon Kim, M.D.2, Chang-Sik Yu, M.D.2, Hee-Cheol Kim, M.D.2, Je-Hwan Lee, M.D.3 and Tae-Won Kim, M.D.3
Place of duty Departments of 1Radiation Oncology, 2General Surgery and 3Medical Oncology, College of Medicine, University of Ulsan, Seoul, Korea
Title Patterns of Failure and Prognostic Factors in Anal Cancer Treated with Radiotherapy
Publicationinfo Cancer Research and Treatment 2003 Apr; 035(02): 141-147.
Key_word Anal neoplasm, Radiotherapy, Patterns of failure
Full-Text
Abstract Purpose: To analyze the patterns of failure and prognostic factors affecting the local control and survivals in anal cancer treated with definitive radiotherapy, and to find the most effective treatment modality.

Materials and Methods: Thirty consecutive patients with primary cancers of the anal canal were treated using radiotherapy with or without 5-FU based concurrent chemotherapy. According to the AJCC tumor stage, six patients had stage I, 11 stage II, 2 stage IIIA and 11 stage IIIB tumors. The median radiation dose was 45 Gy (30∼72 Gy), with 23 patients receiving concurrent chemotherapy (5-FU and mitomycin C in 12 patients, 5-FU and cisplatin in 7, and other drugs in 4). The median follow up period was 43 months, ranging from 8 to 99 months.

Results: Among the 16 patients who were treated without surgical resection prior to radiotherapy, com- plete remission was observed in 12 (75%), partial remission in 3 (19%) and local progression in 1 (6%) patient. The local failures, including persistent disease, were observed in 10 (33%), and the patients with higher T-stages (T3-4) had higher rates of local failure (T1-2, 21% vs. T3-4, 72%, p=0.03). Distant metastases were found in 5 patients (17%). The five year overall and disease free survival rates were 64% and 53%, respectively. The factors affecting the 5 year local relapse free survival were T-stage (74.9% in T1-2 vs. 28.6% in T3-4, p=0.01) and the existence of a gross tumor prior to radiotherapy (84.6%, no residual vs. 45.1% with residual, p=0.03).

Conclusion: A local recurrence was the major failure pattern in anal cancers, and the factors affecting a local failure were the T-stage and tumor volume prior to radiotherapy. Radiation dose around 45 Gy was sufficient to control the earlier T stage tumors, but a higher dose should be considered with more advanced lesions. (Cancer Research and Treatment 2003;35:141-147)