AI Article Synopsis
- - Early-stage anal squamous cell carcinomas (ASCC) are typically treated with chemoradiotherapy (CRT), but the study suggests that radiotherapy (RT) alone may provide similar effectiveness with reduced side effects.
- - The research included 440 patients, with no significant differences in three-year disease-free survival, overall survival, or colostomy-free survival between those treated with CRT and RT.
- - Patients receiving CRT experienced more treatment interruptions and higher levels of severe toxicities compared to those receiving RT, implying that CRT may be less favorable due to increased toxicity and longer treatment times.
Article Abstract
Introduction: Early-stage anal squamous cell carcinomas (ASCC) are usually treated with chemoradiotherapy (CRT), with good outcomes. Radiotherapy (RT) alone might be sufficient while reducing toxicity.
Methods: Patients included in the French prospective FFCD-ANABASE and treated for T1-2N0 ASCC between 2015/01 and 2020/04 were divided into CRT and RT groups. Clinical outcomes and toxicity were reported. Propensity score matching was conducted for 105 pairs of patients.
Results: 440 patients were analyzed: 261 (59.3 %) in the CRT group and 179 (40.7 %) in the RT group. The median follow-up was 35.7 months. Patients receiving CRT were younger, had better Performance Status (PS) and larger tumors. No statistical difference was observed for 3-year Disease-free survival (85.3 % vs 83 %, p = 0.28), Overall survival (89.6 % vs 94.8 %, p = 0.69) and Colostomy-free survival (84.5 % vs 87.2 %, p = 0.84) between CRT and RT groups, respectively. Propensity score-matched analysis confirmed these findings. Treatment interruptions were significantly more frequent in the CRT group (36.3 % vs 21.9 %, p = 0.0013), resulting in an Overall Treatment Time (OTT) extended by 7 days. Grade 3 CTCAE v4.0 toxicities were more prevalent in the CRT group (46 % vs 19 %, p < 0.001).
Conclusion: Adding chemotherapy to radiotherapy did not significantly improve outcomes for T1-2N0 ASCC in our study, but increased toxicity and OTT.
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| http://dx.doi.org/10.1016/j.dld.2024.06.022 | DOI Listing |
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