Treatment outcome and prognostic factors in patients with carcinoma of the anal canal
REN Hua, JING Hao, JIN Jing, LI Ye-xiong, WANG Wei-hu, WANG Shu-Lian, SONG Yong-wen, LIU Yue-ping, FANG Hui, LIU Xin-fan, YU Zi-hao
Department of Radiation Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Pecking Union Medical College, Beijing 100021, China
Abstract：Objective To retrospectively analyze the treatment outcome and prognostic factors in patients with primary carcinoma of the anal canal (CAC). Methods From January 2000 to December 2011, 31 patients with CAC were treated in our institution;of the 31 patients, 23 had squamous cell carcinoma, and 8 had adenocarcinoma. In the initial treatment for stage Ⅰ—Ⅲ patients, 16 were treated with radiotherapy-based modality, 11 with surgery-based modality, and 3 with chemotherapy. Results The follow-up rate was 90%;21 patients were followed up for at least 3 years. The 3-year overall survival (OS) rate and progression-free survival (PFS) rate were 76% and 56%, respectively. The univariate analysis showed that clinical stage and T stage were the prognostic factors for OS (χ2=12.11, P=0.001;χ2=4.64, P=0.031) and marginal prognostic factors for PFS (χ2=2.91, P=0.088;χ2=2.75, P=0.097). There were no significant differences in 3-year OS and PFS between the stage Ⅰ—Ⅲ patients with squamous cell carcinoma who received radiotherapy-based initial treatment and those who received surgery-based initial treatment (80% vs. 80%,χ2=0.08, P=0.776;78% vs. 67%,χ2=0.17, P=0.697). Of the patients treated with radiotherapy, 37% experienced grade 3 acute skin or mucosal toxicity, and 9% experienced impaired anal sensation or function as late toxicity. Conclusions Clinical stage and T stage are the most important prognostic factors in patients with CAC. Concurrent chemoradiotherapy should be the standard radical treatment for squamous cell carcinoma of the anal canal, and using intensity-modulated radiotherapy helps patients to complete the planned course of radiotherapy without severe adverse events.
REN Hua,JING Hao,JIN Jing et al. Treatment outcome and prognostic factors in patients with carcinoma of the anal canal[J]. Chinese Journal of Radiation Oncology, 2013, 22(4): 266-269.
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2013, Vol. 22 
