Temporal improvements in loco-regional failure and survival in patients with anal cancer treated with chemo-radiotherapy: treatment cohort study (1990-2014).
Journal
British journal of cancer
ISSN: 1532-1827
Titre abrégé: Br J Cancer
Pays: England
ID NLM: 0370635
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
06
05
2019
accepted:
28
08
2019
revised:
23
08
2019
pubmed:
15
1
2020
medline:
5
1
2021
entrez:
15
1
2020
Statut:
ppublish
Résumé
We evaluated oncological changes in patients with squamous cell carcinoma of the anus (SCCA) treated by chemoradiotherapy (CRT) from a large UK institute, to derive estimates of contemporary outcomes. We performed a treatment-cohort analysis in 560 patients with non-metastatic SCCA treated with CRT over 25 years. The primary outcomes were 3-year loco-regional failure (LRF), 5-year overall survival (OS), and 5-year cancer-specific survival (CSS). We developed prediction models; and overlaid estimates on published results from historic trials. Age distributions, proportions by gender and cT stage remained stable over time. The median follow-up was 61 (IQR: 36-79) months. Comparing the first period (1990-1994) with the last period (2010-2014), 3-year LRF declined from 33 to 16% (P Current and predicted rates for 3-year LRF and 5-year survivals are considerably improved compared with those in historic trials.
Sections du résumé
BACKGROUND
We evaluated oncological changes in patients with squamous cell carcinoma of the anus (SCCA) treated by chemoradiotherapy (CRT) from a large UK institute, to derive estimates of contemporary outcomes.
METHODS
We performed a treatment-cohort analysis in 560 patients with non-metastatic SCCA treated with CRT over 25 years. The primary outcomes were 3-year loco-regional failure (LRF), 5-year overall survival (OS), and 5-year cancer-specific survival (CSS). We developed prediction models; and overlaid estimates on published results from historic trials.
RESULTS
Age distributions, proportions by gender and cT stage remained stable over time. The median follow-up was 61 (IQR: 36-79) months. Comparing the first period (1990-1994) with the last period (2010-2014), 3-year LRF declined from 33 to 16% (P
CONCLUSIONS
Current and predicted rates for 3-year LRF and 5-year survivals are considerably improved compared with those in historic trials.
Identifiants
pubmed: 31932755
doi: 10.1038/s41416-019-0689-x
pii: 10.1038/s41416-019-0689-x
pmc: PMC7078229
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
749-758Commentaires et corrections
Type : CommentIn
Références
De Angelis, R., Sant, M., Coleman, M. P., Francisci, S., Baili, P., Pierannunzio, D. et al. Cancer survival in Europe 1999–2007 by country and age: results of EUROCARE–5-a population-based study. Lancet Oncol. 15, 23–34 (2014).
doi: 10.1016/S1470-2045(13)70546-1
Howlader, N., Mariotto, A. B., Woloshin, S. & Schwartz, L. M. Providing clinicians and patients with actual prognosis: cancer in the context of competing causes of death. J. Natl Cancer Inst. Monogr. 2014, 255–264 (2014).
doi: 10.1093/jncimonographs/lgu022
Paesmans, M. & Bleiberg, H. Are we cautious enough when we interpret results of randomized but underpowered comparisons? J. Clin. Oncol. 24, 1964–1965 (2006).
doi: 10.1200/JCO.2005.04.9858
Gaziano J. M., Brotons C., Coppolecchia R., Cricelli C., Darius H., Gorelick P. B., et al. Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial. Lancet. 392, 1036–1046 (2018).
Wille-Jorgensen, P., Syk, I., Smedh, K., Laurberg, S., Nielsen, D. T., Petersen, S. H. et al. Effect of more vs less frequent follow-up testing on overall and colorectal cancer-specific mortality in patients with stage II or III colorectal cancer: The COLOFOL randomized clinical trial. JAMA. 319, 2095–2103 (2018).
doi: 10.1001/jama.2018.5623
Jayne, D., Pigazzi, A., Marshall, H., Croft, J., Corrigan, N., Copeland, J. et al. Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR Randomized clinical trial. JAMA. 318, 1569–1580 (2017).
doi: 10.1001/jama.2017.7219
Benson, A. B., Venook, A. P., Al-Hawary, M. M., Cederquist, L., Chen, Y. J., Ciombor, K. K. et al. Anal carcinoma, Version 2.2018, NCCN clinical practice guidelines in oncology. J. Natl Compr. Canc. Netw. 16, 852–871 (2018).
doi: 10.6004/jnccn.2018.0060
Glynne-Jones, R., Nilsson, P. J., Aschele, C., Goh, V., Peiffert, D., Cervantes, A. et al. Anal cancer: ESMO-ESSO-ESTRO clinical practice guidelines for diagnosis, treatment and follow-up. Radiother. Oncol. 111, 330–339 (2014).
doi: 10.1016/j.radonc.2014.04.013
Geh, I., Gollins, S., Renehan, A., Scholefield, J., Goh, V., Prezzi, D. et al. Association of coloproctology of Great Britain & Ireland (ACPGBI): guidelines for the management of cancer of the colon, rectum and anus (2017)—anal cancer. Colorectal Dis. 19(Suppl. 1), 82–97 (2017).
doi: 10.1111/codi.13709
Downing, A., Morris, E. J. A., Aravani, A., Finan, P. J., Lawton, S., Thomas, J. D. et al. The effect of the UK coordinating centre for cancer research anal cancer trial (ACT1) on population-based treatment and survival for squamous cell cancer of the anus. Clin. Oncol. 27, 708–712 (2015).
doi: 10.1016/j.clon.2015.06.019
Sekhar, H., Zwahlen, M., Trelle, S., Malcomson, L., Kochhar, R., Saunders, M. P. et al. Nodal stage migration and prognosis in anal cancer: a systematic review, meta-regression, and simulation study. Lancet Oncol. 18, 1348–1359 (2017).
doi: 10.1016/S1470-2045(17)30456-4
Renehan, A. G., Saunders, M. P., Schofield, P. F. & O'Dwyer, S. T. Patterns of local disease failure and outcome after salvage surgery in patients with anal cancer. Br. J. Surg. 92, 605–614 (2005).
doi: 10.1002/bjs.4908
Kochhar R., Renehan A. G., Mullan D., Chakrabarty B., Saunders M. P., Carrington B. M. The assessment of local response using magnetic resonance imaging at 3- and 6-month post chemoradiotherapy in patients with anal cancer. Eur. Radiol. 27, 607–617 (2016).
Edge, S. B., Byrd, D. R., Compton, C. C., Fritz, A. G., Greene, F. I. & Trotti, A. I. AJCC Cancer Staging Manual 7th editor. (Springer, New York, 2009).
Northover, J. M. A., Arnott, S. J., Cunningham, D., Gallagher, J., Gray, R., Hardcastle, J. et al. Epidermoid anal cancer: results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycin. Lancet. 348, 1049–1054 (1996).
doi: 10.1016/S0140-6736(96)03409-5
James, R. D., Glynne-Jones, R., Meadows, H. M., Cunningham, D., Myint, A. S., Saunders, M. P. et al. Mitomycin or cisplatin chemoradiation with or without maintenance chemotherapy for treatment of squamous-cell carcinoma of the anus (ACT II): a randomised, phase 3, open-label, 2×2 factorial trial. Lancet Oncol. 14, 516–524 (2013).
doi: 10.1016/S1470-2045(13)70086-X
Fish, R., Sanders, C., Adams, R., Brewer, J., Brookes, S. T., DeNardo, J. et al. A core outcome set for clinical trials of chemoradiotherapy interventions for anal cancer (CORMAC): a patient and health-care professional consensus. Lancet Gastroenterol. Hepatol. 3, 865–873 (2018).
doi: 10.1016/S2468-1253(18)30264-4
Flam, M., John, M., Pajak, T. F., Petrelli, N., Myerson, R., Doggett, S. et al. Role of mitomycin in combination with fluorouracil and radiotherapy, and of salvage chemoradiation in the definitive nonsurgical treatment of epidermoid carcinoma of the anal canal: results of a phase III randomized intergroup study. J. Clin. Oncol. 14, 2527–2539 (1996).
doi: 10.1200/JCO.1996.14.9.2527
Bartelink, H., Roelofsen, F., Eschwege, F., Rougier, P., Bosset, J. F., Gonzalez, D. G. et al. Concomitant radiotherapy and chemotherapy is superior to radiotherapy alone in the treatment of locally advanced anal cancer: results of a phase III randomized trial of the European organization for research and treatment of cancer radiotherapy and gastrointestinal cooperative groups. J. Clini. Oncol. 15, 2040–2049 (1997).
doi: 10.1200/JCO.1997.15.5.2040
Ajani, J. A., Winter, K. A., Gunderson, L. L., Pedersen, J., Benson, A. B. 3rd, Thomas, C. R. Jr. et al. Fluorouracil, mitomycin, and radiotherapy vs fluorouracil, cisplatin, and radiotherapy for carcinoma of the anal canal: a randomized controlled trial. JAMA. 299, 1914–1921 (2008).
doi: 10.1001/jama.299.16.1914
Peiffert, D., Tournier-Rangeard, L., Gerard, J. P., Lemanski, C., Francois, E., Giovannini, M. et al. Induction chemotherapy and dose intensification of the radiation boost in locally advanced anal canal carcinoma: final analysis of the randomized UNICANCER ACCORD 03 trial. J. Clin. Oncol. 30, 1941–1948 (2012).
doi: 10.1200/JCO.2011.35.4837
Islami F., Ferlay J., Lortet-Tieulent J., Bray F., Jemal A. International trends in anal cancer incidence rates. Int. J. Epidemiol. 46, 924–938 (2016)
Myerson, R. J., Kong, F., Birnbaum, E. H., Fleshman, J. W., Kodner, I. J., Picus, J. et al. Radiation therapy for epidermoid carcinoma of the anal canal, clinical and treatment factors associated with outcome. Radiother. Oncol. 61, 15–22 (2001).
doi: 10.1016/S0167-8140(01)00404-2
Kim, H. J., Huh, J. W., Kim, C. H., Lim, S. W., Nam, T. K., Kim, H. R. et al. Long-term outcomes of chemoradiation for anal cancer patients. Yonsei Med. J. 54, 108–115 (2013).
doi: 10.3349/ymj.2013.54.1.108
Tomaszewski, J. M., Link, E., Leong, T., Heriot, A., Vazquez, M., Chander, S. et al. Twenty-five-year experience with radical chemoradiation for anal cancer. Int. J. Radiat. Oncol. Biol. Phys. 83, 552–558 (2012).
doi: 10.1016/j.ijrobp.2011.07.007
Whiteford, M. H., Stevens, K. R. Jr., Oh, S., Deveney, K. E., Billingham, R., O'Connell, T. X. et al. The evolving treatment of anal cancer: how are we doing? Arch. Surg. 136, 886–891 (2001).
doi: 10.1001/archsurg.136.8.886
Guren, M. G., Aagnes, B., Nygard, M., Dahl, O. & Moller, B. Rising Incidence and improved survival of anal squamous cell carcinoma in Norway, 1987–2016. Clin. Colorectal Cancer. 18, e96–e103 (2019).
doi: 10.1016/j.clcc.2018.10.001
Nilsson, P. J., Svensson, C., Goldman, S., Ljungqvist, O. & Glimelius, B. Epidermoid anal cancer: a review of a population-based series of 308 consecutive patients treated according to prospective protocols. Int. J. Radiat. Oncol. Biol. Phys. 61, 92–102 (2005).
doi: 10.1016/j.ijrobp.2004.03.034
Glynne-Jones, R., Sebag-Montefiore, D., Meadows, H. M., Cunningham, D., Begum, R., Adab, F. et al. Best time to assess complete clinical response after chemoradiotherapy in squamous cell carcinoma of the anus (ACT II): a post-hoc analysis of randomised controlled phase 3 trial. Lancet Oncol. 18, 347–356 (2017).
doi: 10.1016/S1470-2045(17)30071-2
PLATO_trial. PersonaLising anal cancer radiotherapy dose—incorporating ACT3, ACT4 and ACT5. http://medhealth.leeds.ac.uk/info/430/solid_tumours/2210/plato (2018).
Baricevic, I., He, X., Chakrabarty, B., Oliver, A. W., Bailey, C., Summers, J. et al. High-sensitivity human papilloma virus genotyping reveals near universal positivity in anal squamous cell carcinoma: different implications for vaccine prevention and prognosis. Eur. J. Cancer. 51, 776–785 (2015).
doi: 10.1016/j.ejca.2015.01.058
Jones, C. M., Adams, R., Downing, A., Glynne-Jones, R., Harrison, M., Hawkins, M. et al. Toxicity, tolerability, and compliance of concurrent capecitabine or 5-fluorouracil in radical management of anal cancer with single-dose mitomycin-C and intensity modulated radiation therapy: Evaluation of a National Cohort. Int. J. Radiat. Oncol. Biol. Phys. 101, 1202–1211 (2018).
doi: 10.1016/j.ijrobp.2018.04.033
Kachnic, L. A., Winter, K., Myerson, R. J., Goodyear, M. D., Willins, J., Esthappan, J. et al. RTOG 0529: a phase 2 evaluation of dose-painted intensity modulated radiation therapy in combination with 5-fluorouracil and mitomycin-C for the reduction of acute morbidity in carcinoma of the anal canal. Int. J. Radiat. Oncol. Biol. Phys. 86, 27–33 (2013).
doi: 10.1016/j.ijrobp.2012.09.023