Anal canal carcinoma:: early-stage tumors ≤10 mm (T1 or Tis):: Therapeutic options and original pattern of local failure after radiotherapy
Anal canal carcinoma:: early-stage tumors ≤10 mm (T1 or Tis):: Therapeutic options and original pattern of local failure after radiotherapy
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DOI：
10.1016/j.ijrobp.2004.09.060
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发表时间：
2005-06-01
影响因子：
7
通讯作者：
Gerard, JP
中科院分区：
文献类型：
--
作者：
Ortholan, C;Ramaioli, A;Gerard, JP
目的：调查的临床历史，管理，和模式的复发非常早期的肛管癌在法国的回顾性surveillance.Methods：研究组包括69例Tis期和T1肛管癌：51厘米治疗1990年至2000年（12原位，57侵入，66阶段NO，3阶段NI）。患者的中位年龄为67岁（范围：27-83岁）。69例患者中，66例接受了放疗（RT），3例原位病变仅接受局部切除治疗，而没有RT。26例患者在RT前接受了局部切除（12例阴性，14例手术切缘阳性）。在接受放疗的66例患者中，8例仅接受近距离放疗（中位剂量，55戈伊），38例接受外照射放疗（中位剂量，45戈伊）加近距离放疗加强（中位剂量，20戈伊），20例仅接受外照射放疗（中位剂量，55戈伊）。在接受RT治疗的66例患者中，6例发生局部复发，中位间隔为50个月（范围，13-78个月）。4例患者在初始肿瘤床外发生局部失败。3例Tis单纯切除治疗，我开发的局部复发。既往切除、剂量和局部失败之间无相关性。5年总生存率、无结肠造口生存率和无病生存率分别为94%、85%和89%。晚期并发症（1-3级）的发生率为28%，是14%的那些谁收到剂量< 60 Gy and 37% for those who received doses of >= 60戈伊（p = 0.04）。结论：大多数复发发生后，治疗后很长一段时间的无病间隔，往往以外的初始肿瘤部位。这些小的肛门癌可以通过使用小体积和中等剂量（对于亚临床病变为40-50戈伊，对于T1为50-60戈伊）的RT来治疗。(c)2005年爱思唯尔公司
Purpose: To investigate the clinical history, management, and pattern of recurrence of very early-stage anal canal cancer in a French retrospective survey.Methods: The study group consisted of 69 patients with Stage Tis and T1 anal canal carcinoma :51 cm treated between 1990 and 2000 (12 were in situ, 57 invasive, 66 Stage NO, and 3 Stage NI). The median patient age was 67 years (range, 27-83 years). Of the 69 patients, 66 received radiotherapy (RT) and 3 with in situ disease were treated by local excision alone without RT. Twenty-six patients underwent local excision before RT (12 with negative and 14 with positive surgical margins). Of the 66 patients who underwent RT, 8 underwent brachytherapy alone (median dose, 55 Gy), 38 underwent external beam RT (median dose, 45 Gy) plus a brachytherapy boost (median boost dose, 20 Gy), and 20 underwent external beam RT alone (median dose, 55 Gy).Results: Of the 69 patients, 68 had initial local control. Of the 66 patients treated by RT, 6 developed local recurrence at a median interval of 50 months (range, 13-78 months). Four patients developed local failure outside the initial tumor bed. Of the 3 patients with Tis treated by excision alone, I developed local recurrence. No relation was found among prior excision, dose, and local failure. The 5-year overall survival, colostomy-free survival, and disease-free survival rate was 94%, 85%, and 89%, respectively. The rate of late complications (Grade 1-3) was 28% and was 14% for those who received doses < 60 Gy and 37% for those who received doses of >= 60 Gy (p = 0.04).Conclusion: Most recurrences occurred after a long disease-free interval after treatment and often outside the initial tumor site. These small anal cancers could be treated by RT using a small volume and moderate dose (40-50 Gy for subclinical lesions and 50-60 Gy for T1). (c) 2005 Elsevier Inc.