Squamous Cell Carcinoma of the Anal Canal: Patterns and Predictors of Failure and Implications for Intensity-Modulated Radiation Treatment Planning
Purpose Intensity-modulated radiation treatment (IMRT) is increasingly used in the treatment of squamous cell carcinoma of the anal canal (SCCAC). Prevention of locoregional failure (LRF) using IMRT requires appropriate clinical target volume (CTV) definition. To better define the CTV for IMRT, we e...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2010-11, Vol.78 (4), p.1064-1072 |
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| creator | Wright, Jean L., M.D Patil, Sujata M., Ph.D Temple, Larissa K.F., M.D Minsky, Bruce D., M.D Saltz, Leonard B., M.D Goodman, Karyn A., M.D |
| description | Purpose Intensity-modulated radiation treatment (IMRT) is increasingly used in the treatment of squamous cell carcinoma of the anal canal (SCCAC). Prevention of locoregional failure (LRF) using IMRT requires appropriate clinical target volume (CTV) definition. To better define the CTV for IMRT, we evaluated patterns and predictors of LRF in SCCAC patients given conventional radiation treatment. Methods and Materials We reviewed records of 180 SCCAC patients treated with conventional radiation with or without chemotherapy at our institution between January 1990 and March 2007. All patients received radiation; the median primary tumor dose was 45 Gy. A total of 173 patients also received mitomycin-based chemotherapy. Results Median follow-up was 40 months. Actuarial 3-year colostomy-free survival was 89% and overall survival (OS) 88%. Actuarial 3-year LRF was 23%. A total of 45 patients had LRF, with 35 (78%) occurring locally in the primary site (25 local only, 10 local and regional); however, 20 (44%) had regional components of failure within the pelvis or inguinal nodes (10 regional only, 10 local and regional). Cumulative sites of LRF (patients may have one or more site of failure) were as follows: primary, 35; inguinal, 8; external perianal, 5; common iliac, 4; presacral, 3; distal rectum, 2; external iliac, 2; and internal iliac, 2. All patients with common iliac failure had cT3 or N+ disease. Conclusions The observed patterns of failure support inclusion of the inguinal and all pelvic nodal groups in the CTV for IMRT. In patients with advanced tumor or nodal stage, common iliac nodes should also be included in the CTV. |
| doi_str_mv | 10.1016/j.ijrobp.2009.09.029 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_21438041</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0360301609032714</els_id><sourcerecordid>954585293</sourcerecordid><originalsourceid>FETCH-LOGICAL-c572t-dc9397457f7d1ce13debabcc7e3c3af984ee9db67ee30b6a69c678cfb96217613</originalsourceid><addsrcrecordid>eNqFkt-K1DAUxoMo7jj6BiIBEa865k_bNF4Iy-DqwIqDu4J3IU1P3YxtMpukwjyHL2y6Myp4s3BIIPnlnJzvOwg9p2RFCa3f7FZ2F3y7XzFC5GoOJh-gBW2ELHhVfXuIFoTXpOAZPkNPYtwRQigV5WN0xgiviJB8gX5d3U569FPEaxgGvNbBWOdHjX2P0w3gc6fn07y-xVudEgQXsXYd3gborEk-xBm90HaYAtzdbMb9YI1O1me09wFvXAIXbToUn3w3DTpBh7_ozt4h-DqATiO4hLeDds6670_Ro14PEZ6d9iX6evH-ev2xuPz8YbM-vyxMJVgqOiO5FGUletFRA5R30OrWGAHccN3LpgSQXVsLAE7aWtfS1KIxfStrRkVN-RK9POb1MVkVjU1gbox3DkxSjJa8IeVMvT5S--BvJ4hJjTaaLJZ2kHVTsiqrpmKS30uKmjBeMlFnsjySJvgYA_RqH-yow0FRomZ31U4d3VWzu2qOXGGJXpwKTO0I3d9Hf-zMwKsToKPRQx-0Mzb-4zhvRCnKzL07cpDl_WkhzN2DM9nSMDffeXvfT_5PYAbrsuvDDzhA3Pkp5JGJiqrIFFFX8yTOg0gk4UxkaX8DBkrbfg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>760234276</pqid></control><display><type>article</type><title>Squamous Cell Carcinoma of the Anal Canal: Patterns and Predictors of Failure and Implications for Intensity-Modulated Radiation Treatment Planning</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Wright, Jean L., M.D ; Patil, Sujata M., Ph.D ; Temple, Larissa K.F., M.D ; Minsky, Bruce D., M.D ; Saltz, Leonard B., M.D ; Goodman, Karyn A., M.D</creator><creatorcontrib>Wright, Jean L., M.D ; Patil, Sujata M., Ph.D ; Temple, Larissa K.F., M.D ; Minsky, Bruce D., M.D ; Saltz, Leonard B., M.D ; Goodman, Karyn A., M.D</creatorcontrib><description>Purpose Intensity-modulated radiation treatment (IMRT) is increasingly used in the treatment of squamous cell carcinoma of the anal canal (SCCAC). Prevention of locoregional failure (LRF) using IMRT requires appropriate clinical target volume (CTV) definition. To better define the CTV for IMRT, we evaluated patterns and predictors of LRF in SCCAC patients given conventional radiation treatment. Methods and Materials We reviewed records of 180 SCCAC patients treated with conventional radiation with or without chemotherapy at our institution between January 1990 and March 2007. All patients received radiation; the median primary tumor dose was 45 Gy. A total of 173 patients also received mitomycin-based chemotherapy. Results Median follow-up was 40 months. Actuarial 3-year colostomy-free survival was 89% and overall survival (OS) 88%. Actuarial 3-year LRF was 23%. A total of 45 patients had LRF, with 35 (78%) occurring locally in the primary site (25 local only, 10 local and regional); however, 20 (44%) had regional components of failure within the pelvis or inguinal nodes (10 regional only, 10 local and regional). Cumulative sites of LRF (patients may have one or more site of failure) were as follows: primary, 35; inguinal, 8; external perianal, 5; common iliac, 4; presacral, 3; distal rectum, 2; external iliac, 2; and internal iliac, 2. All patients with common iliac failure had cT3 or N+ disease. Conclusions The observed patterns of failure support inclusion of the inguinal and all pelvic nodal groups in the CTV for IMRT. In patients with advanced tumor or nodal stage, common iliac nodes should also be included in the CTV.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2009.09.029</identifier><identifier>PMID: 20350793</identifier><identifier>CODEN: IOBPD3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anal carcinoma ; ANTI-INFECTIVE AGENTS ; ANTIBIOTICS ; ANTIMITOTIC DRUGS ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; ANTINEOPLASTIC DRUGS ; Anus Neoplasms - drug therapy ; Anus Neoplasms - mortality ; Anus Neoplasms - prevention & control ; Anus Neoplasms - radiotherapy ; Biological and medical sciences ; BODY ; Canals ; Carcinoma, Squamous Cell - drug therapy ; Carcinoma, Squamous Cell - mortality ; Carcinoma, Squamous Cell - prevention & control ; Carcinoma, Squamous Cell - radiotherapy ; CARCINOMAS ; Chemoradiation ; CHEMOTHERAPY ; DIGESTIVE SYSTEM ; DISEASES ; DRUGS ; FAILURES ; Female ; Fluorouracil - administration & dosage ; Gastroenterology. Liver. Pancreas. Abdomen ; GASTROINTESTINAL TRACT ; Hematology, Oncology and Palliative Medicine ; Humans ; Intensity-modulated radiation treatment ; INTESTINES ; LARGE INTESTINE ; Lymphatic Irradiation ; Lymphatic Metastasis ; Male ; Medical sciences ; MEDICINE ; Middle Aged ; MITOMYCIN ; Mitomycin - administration & dosage ; Neoplasm Recurrence, Local - prevention & control ; Neoplasm Staging ; NEOPLASMS ; NUCLEAR MEDICINE ; ORGANIC COMPOUNDS ; ORGANS ; Patterns of failure ; Predictors of failure ; RADIOLOGY ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted - methods ; Radiotherapy, Intensity-Modulated - methods ; RECTUM ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; THERAPY ; Treatment Failure ; Tumor Burden ; Tumors</subject><ispartof>International journal of radiation oncology, biology, physics, 2010-11, Vol.78 (4), p.1064-1072</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2010 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c572t-dc9397457f7d1ce13debabcc7e3c3af984ee9db67ee30b6a69c678cfb96217613</citedby><cites>FETCH-LOGICAL-c572t-dc9397457f7d1ce13debabcc7e3c3af984ee9db67ee30b6a69c678cfb96217613</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijrobp.2009.09.029$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3549,27923,27924,45994</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23387474$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20350793$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/21438041$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Wright, Jean L., M.D</creatorcontrib><creatorcontrib>Patil, Sujata M., Ph.D</creatorcontrib><creatorcontrib>Temple, Larissa K.F., M.D</creatorcontrib><creatorcontrib>Minsky, Bruce D., M.D</creatorcontrib><creatorcontrib>Saltz, Leonard B., M.D</creatorcontrib><creatorcontrib>Goodman, Karyn A., M.D</creatorcontrib><title>Squamous Cell Carcinoma of the Anal Canal: Patterns and Predictors of Failure and Implications for Intensity-Modulated Radiation Treatment Planning</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose Intensity-modulated radiation treatment (IMRT) is increasingly used in the treatment of squamous cell carcinoma of the anal canal (SCCAC). Prevention of locoregional failure (LRF) using IMRT requires appropriate clinical target volume (CTV) definition. To better define the CTV for IMRT, we evaluated patterns and predictors of LRF in SCCAC patients given conventional radiation treatment. Methods and Materials We reviewed records of 180 SCCAC patients treated with conventional radiation with or without chemotherapy at our institution between January 1990 and March 2007. All patients received radiation; the median primary tumor dose was 45 Gy. A total of 173 patients also received mitomycin-based chemotherapy. Results Median follow-up was 40 months. Actuarial 3-year colostomy-free survival was 89% and overall survival (OS) 88%. Actuarial 3-year LRF was 23%. A total of 45 patients had LRF, with 35 (78%) occurring locally in the primary site (25 local only, 10 local and regional); however, 20 (44%) had regional components of failure within the pelvis or inguinal nodes (10 regional only, 10 local and regional). Cumulative sites of LRF (patients may have one or more site of failure) were as follows: primary, 35; inguinal, 8; external perianal, 5; common iliac, 4; presacral, 3; distal rectum, 2; external iliac, 2; and internal iliac, 2. All patients with common iliac failure had cT3 or N+ disease. Conclusions The observed patterns of failure support inclusion of the inguinal and all pelvic nodal groups in the CTV for IMRT. In patients with advanced tumor or nodal stage, common iliac nodes should also be included in the CTV.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anal carcinoma</subject><subject>ANTI-INFECTIVE AGENTS</subject><subject>ANTIBIOTICS</subject><subject>ANTIMITOTIC DRUGS</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>ANTINEOPLASTIC DRUGS</subject><subject>Anus Neoplasms - drug therapy</subject><subject>Anus Neoplasms - mortality</subject><subject>Anus Neoplasms - prevention & control</subject><subject>Anus Neoplasms - radiotherapy</subject><subject>Biological and medical sciences</subject><subject>BODY</subject><subject>Canals</subject><subject>Carcinoma, Squamous Cell - drug therapy</subject><subject>Carcinoma, Squamous Cell - mortality</subject><subject>Carcinoma, Squamous Cell - prevention & control</subject><subject>Carcinoma, Squamous Cell - radiotherapy</subject><subject>CARCINOMAS</subject><subject>Chemoradiation</subject><subject>CHEMOTHERAPY</subject><subject>DIGESTIVE SYSTEM</subject><subject>DISEASES</subject><subject>DRUGS</subject><subject>FAILURES</subject><subject>Female</subject><subject>Fluorouracil - administration & dosage</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>GASTROINTESTINAL TRACT</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Intensity-modulated radiation treatment</subject><subject>INTESTINES</subject><subject>LARGE INTESTINE</subject><subject>Lymphatic Irradiation</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>MEDICINE</subject><subject>Middle Aged</subject><subject>MITOMYCIN</subject><subject>Mitomycin - administration & dosage</subject><subject>Neoplasm Recurrence, Local - prevention & control</subject><subject>Neoplasm Staging</subject><subject>NEOPLASMS</subject><subject>NUCLEAR MEDICINE</subject><subject>ORGANIC COMPOUNDS</subject><subject>ORGANS</subject><subject>Patterns of failure</subject><subject>Predictors of failure</subject><subject>RADIOLOGY</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy Planning, Computer-Assisted - methods</subject><subject>Radiotherapy, Intensity-Modulated - methods</subject><subject>RECTUM</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>THERAPY</subject><subject>Treatment Failure</subject><subject>Tumor Burden</subject><subject>Tumors</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkt-K1DAUxoMo7jj6BiIBEa865k_bNF4Iy-DqwIqDu4J3IU1P3YxtMpukwjyHL2y6Myp4s3BIIPnlnJzvOwg9p2RFCa3f7FZ2F3y7XzFC5GoOJh-gBW2ELHhVfXuIFoTXpOAZPkNPYtwRQigV5WN0xgiviJB8gX5d3U569FPEaxgGvNbBWOdHjX2P0w3gc6fn07y-xVudEgQXsXYd3gborEk-xBm90HaYAtzdbMb9YI1O1me09wFvXAIXbToUn3w3DTpBh7_ozt4h-DqATiO4hLeDds6670_Ro14PEZ6d9iX6evH-ev2xuPz8YbM-vyxMJVgqOiO5FGUletFRA5R30OrWGAHccN3LpgSQXVsLAE7aWtfS1KIxfStrRkVN-RK9POb1MVkVjU1gbox3DkxSjJa8IeVMvT5S--BvJ4hJjTaaLJZ2kHVTsiqrpmKS30uKmjBeMlFnsjySJvgYA_RqH-yow0FRomZ31U4d3VWzu2qOXGGJXpwKTO0I3d9Hf-zMwKsToKPRQx-0Mzb-4zhvRCnKzL07cpDl_WkhzN2DM9nSMDffeXvfT_5PYAbrsuvDDzhA3Pkp5JGJiqrIFFFX8yTOg0gk4UxkaX8DBkrbfg</recordid><startdate>20101115</startdate><enddate>20101115</enddate><creator>Wright, Jean L., M.D</creator><creator>Patil, Sujata M., Ph.D</creator><creator>Temple, Larissa K.F., M.D</creator><creator>Minsky, Bruce D., M.D</creator><creator>Saltz, Leonard B., M.D</creator><creator>Goodman, Karyn A., M.D</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7U7</scope><scope>C1K</scope><scope>OTOTI</scope></search><sort><creationdate>20101115</creationdate><title>Squamous Cell Carcinoma of the Anal Canal: Patterns and Predictors of Failure and Implications for Intensity-Modulated Radiation Treatment Planning</title><author>Wright, Jean L., M.D ; Patil, Sujata M., Ph.D ; Temple, Larissa K.F., M.D ; Minsky, Bruce D., M.D ; Saltz, Leonard B., M.D ; Goodman, Karyn A., M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c572t-dc9397457f7d1ce13debabcc7e3c3af984ee9db67ee30b6a69c678cfb96217613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anal carcinoma</topic><topic>ANTI-INFECTIVE AGENTS</topic><topic>ANTIBIOTICS</topic><topic>ANTIMITOTIC DRUGS</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>ANTINEOPLASTIC DRUGS</topic><topic>Anus Neoplasms - drug therapy</topic><topic>Anus Neoplasms - mortality</topic><topic>Anus Neoplasms - prevention & control</topic><topic>Anus Neoplasms - radiotherapy</topic><topic>Biological and medical sciences</topic><topic>BODY</topic><topic>Canals</topic><topic>Carcinoma, Squamous Cell - drug therapy</topic><topic>Carcinoma, Squamous Cell - mortality</topic><topic>Carcinoma, Squamous Cell - prevention & control</topic><topic>Carcinoma, Squamous Cell - radiotherapy</topic><topic>CARCINOMAS</topic><topic>Chemoradiation</topic><topic>CHEMOTHERAPY</topic><topic>DIGESTIVE SYSTEM</topic><topic>DISEASES</topic><topic>DRUGS</topic><topic>FAILURES</topic><topic>Female</topic><topic>Fluorouracil - administration & dosage</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>GASTROINTESTINAL TRACT</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Intensity-modulated radiation treatment</topic><topic>INTESTINES</topic><topic>LARGE INTESTINE</topic><topic>Lymphatic Irradiation</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>MEDICINE</topic><topic>Middle Aged</topic><topic>MITOMYCIN</topic><topic>Mitomycin - administration & dosage</topic><topic>Neoplasm Recurrence, Local - prevention & control</topic><topic>Neoplasm Staging</topic><topic>NEOPLASMS</topic><topic>NUCLEAR MEDICINE</topic><topic>ORGANIC COMPOUNDS</topic><topic>ORGANS</topic><topic>Patterns of failure</topic><topic>Predictors of failure</topic><topic>RADIOLOGY</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy Planning, Computer-Assisted - methods</topic><topic>Radiotherapy, Intensity-Modulated - methods</topic><topic>RECTUM</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>THERAPY</topic><topic>Treatment Failure</topic><topic>Tumor Burden</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wright, Jean L., M.D</creatorcontrib><creatorcontrib>Patil, Sujata M., Ph.D</creatorcontrib><creatorcontrib>Temple, Larissa K.F., M.D</creatorcontrib><creatorcontrib>Minsky, Bruce D., M.D</creatorcontrib><creatorcontrib>Saltz, Leonard B., M.D</creatorcontrib><creatorcontrib>Goodman, Karyn A., M.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wright, Jean L., M.D</au><au>Patil, Sujata M., Ph.D</au><au>Temple, Larissa K.F., M.D</au><au>Minsky, Bruce D., M.D</au><au>Saltz, Leonard B., M.D</au><au>Goodman, Karyn A., M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Squamous Cell Carcinoma of the Anal Canal: Patterns and Predictors of Failure and Implications for Intensity-Modulated Radiation Treatment Planning</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2010-11-15</date><risdate>2010</risdate><volume>78</volume><issue>4</issue><spage>1064</spage><epage>1072</epage><pages>1064-1072</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><coden>IOBPD3</coden><abstract>Purpose Intensity-modulated radiation treatment (IMRT) is increasingly used in the treatment of squamous cell carcinoma of the anal canal (SCCAC). Prevention of locoregional failure (LRF) using IMRT requires appropriate clinical target volume (CTV) definition. To better define the CTV for IMRT, we evaluated patterns and predictors of LRF in SCCAC patients given conventional radiation treatment. Methods and Materials We reviewed records of 180 SCCAC patients treated with conventional radiation with or without chemotherapy at our institution between January 1990 and March 2007. All patients received radiation; the median primary tumor dose was 45 Gy. A total of 173 patients also received mitomycin-based chemotherapy. Results Median follow-up was 40 months. Actuarial 3-year colostomy-free survival was 89% and overall survival (OS) 88%. Actuarial 3-year LRF was 23%. A total of 45 patients had LRF, with 35 (78%) occurring locally in the primary site (25 local only, 10 local and regional); however, 20 (44%) had regional components of failure within the pelvis or inguinal nodes (10 regional only, 10 local and regional). Cumulative sites of LRF (patients may have one or more site of failure) were as follows: primary, 35; inguinal, 8; external perianal, 5; common iliac, 4; presacral, 3; distal rectum, 2; external iliac, 2; and internal iliac, 2. All patients with common iliac failure had cT3 or N+ disease. Conclusions The observed patterns of failure support inclusion of the inguinal and all pelvic nodal groups in the CTV for IMRT. In patients with advanced tumor or nodal stage, common iliac nodes should also be included in the CTV.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20350793</pmid><doi>10.1016/j.ijrobp.2009.09.029</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0360-3016 |
| ispartof | International journal of radiation oncology, biology, physics, 2010-11, Vol.78 (4), p.1064-1072 |
| issn | 0360-3016 1879-355X |
| language | eng |
| recordid | cdi_osti_scitechconnect_21438041 |
| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adult Aged Aged, 80 and over Anal carcinoma ANTI-INFECTIVE AGENTS ANTIBIOTICS ANTIMITOTIC DRUGS Antineoplastic Combined Chemotherapy Protocols - therapeutic use ANTINEOPLASTIC DRUGS Anus Neoplasms - drug therapy Anus Neoplasms - mortality Anus Neoplasms - prevention & control Anus Neoplasms - radiotherapy Biological and medical sciences BODY Canals Carcinoma, Squamous Cell - drug therapy Carcinoma, Squamous Cell - mortality Carcinoma, Squamous Cell - prevention & control Carcinoma, Squamous Cell - radiotherapy CARCINOMAS Chemoradiation CHEMOTHERAPY DIGESTIVE SYSTEM DISEASES DRUGS FAILURES Female Fluorouracil - administration & dosage Gastroenterology. Liver. Pancreas. Abdomen GASTROINTESTINAL TRACT Hematology, Oncology and Palliative Medicine Humans Intensity-modulated radiation treatment INTESTINES LARGE INTESTINE Lymphatic Irradiation Lymphatic Metastasis Male Medical sciences MEDICINE Middle Aged MITOMYCIN Mitomycin - administration & dosage Neoplasm Recurrence, Local - prevention & control Neoplasm Staging NEOPLASMS NUCLEAR MEDICINE ORGANIC COMPOUNDS ORGANS Patterns of failure Predictors of failure RADIOLOGY RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted - methods Radiotherapy, Intensity-Modulated - methods RECTUM Stomach. Duodenum. Small intestine. Colon. Rectum. Anus THERAPY Treatment Failure Tumor Burden Tumors |
| title | Squamous Cell Carcinoma of the Anal Canal: Patterns and Predictors of Failure and Implications for Intensity-Modulated Radiation Treatment Planning |
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