Intensity‐modulated radiation therapy versus conventional radiation therapy for squamous cell carcinoma of the anal canal
BACKGROUND: The purpose of this study was to compare outcomes in patients with anal canal squamous cell carcinoma (SCCA) who were treated with definitive chemoradiotherapy by either intensity‐modulated radiation therapy (IMRT) or conventional radiotherapy (CRT). METHODS: Forty‐six patients who recei...
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| Veröffentlicht in: | Cancer 2011-08, Vol.117 (15), p.3342-3351 |
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| creator | Bazan, Jose G. Hara, Wendy Hsu, Annie Kunz, Pamela A. Ford, James Fisher, George A. Welton, Mark L. Shelton, Andrew Kapp, Daniel S. Koong, Albert C. Goodman, Karyn A. Chang, Daniel T. |
| description | BACKGROUND:
The purpose of this study was to compare outcomes in patients with anal canal squamous cell carcinoma (SCCA) who were treated with definitive chemoradiotherapy by either intensity‐modulated radiation therapy (IMRT) or conventional radiotherapy (CRT).
METHODS:
Forty‐six patients who received definitive chemoradiotherapy from January 1993 to August 2009 were included. Forty‐five patients received 5‐fluorouracil with mitomycin C (n = 39) or cisplatin (n = 6). Seventeen (37%) were treated with CRT and 29 (63%) with IMRT. The median dose was 54 Gy in both groups. Median follow‐up was 26 months (CRT) and 32 months (IMRT). T3‐T4 stage (P = .18) and lymph node‐positive disease (P = .6) were similar between groups.
RESULTS:
The CRT group required longer treatment duration (57 days vs 40 days, P < .0001), more treatment breaks (88% vs 34.5%, P = .001), and longer breaks (12 days vs 1.5 days, P < .0001) than patients treated with IMRT. Eleven (65%) patients in the CRT group experienced grade >2 nonhematologic toxicity compared with 6 (21%) patients in the IMRT group (P = .003). The 3‐year overall survival (OS), locoregional control (LRC), and progression‐free survival were 87.8%, 91.9%, and 84.2%, respectively, for the IMRT groups and 51.8%, 56.7%, and 56.7%, respectively, for the CRT group (all P < .01). On multivariate analysis, T stage, use of IMRT, and treatment duration were associated with OS, and T stage and use of IMRT were associated with LRC.
CONCLUSIONS:
The use of IMRT was associated with less toxicity, reduced need for treatment breaks, and excellent LRC and OS compared with CRT in patients with SCCA of the anal canal. Cancer 2011. © 2011 American Cancer Society.
Patients with squamous cell carcinoma of the anal canal were compared by treatment, either conventional radiotherapy (CRT) or intensity‐modulated radiotherapy (IMRT). In patients treated with IMRT, the results were improved toxicity profile, reduced frequency of treatment breaks, shorter duration of overall therapy, and excellent locoregional control and overall survival. |
| doi_str_mv | 10.1002/cncr.25901 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1492614428</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1492614428</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4271-744e17d581003d1d08f7371468022bfb73448d4e25e17b107b9aae4c105726c3</originalsourceid><addsrcrecordid>eNp90MtKxDAUBuAgijOObnwA6UYQoWNubTpLKV4GBgWZhbtymqZYaZOZpB0pbnwEn9EnsbWjbsRNQsiXc05-hI4JnhKM6YXU0k5pMMNkB40JngkfE0530RhjHPkBZ48jdODcc3cUNGD7aEQJjUTA8Bi9znWttCvq9uPtvTJZU0KtMs9CVkBdGO3VT8rCqvU2yrrGedLojdL9DZR_qNxYz60bqExvVVl6EqwstKnAM3nPPOhfyn49RHs5lE4dbfcJWl5fLeNbf3F_M48vF77kVBBfcK6IyIKo-yzLSIajXDBBeBhhStM8FYzzKOOKBh1LCRbpDEBxSXAgaCjZBJ0NZVfWrBvl6qQqXD8baNWNmRA-oyHhnEYdPR-otMY5q_JkZYsKbJsQnPRZJ33WyVfWHT7Z1m3SSmU_9DvcDpxuATgJZW5By8L9Os5CxijtHBncS1Gq9p-WSXwXPwzNPwGabJj0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1492614428</pqid></control><display><type>article</type><title>Intensity‐modulated radiation therapy versus conventional radiation therapy for squamous cell carcinoma of the anal canal</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Wiley Online Library (Open Access Collection)</source><source>Alma/SFX Local Collection</source><creator>Bazan, Jose G. ; Hara, Wendy ; Hsu, Annie ; Kunz, Pamela A. ; Ford, James ; Fisher, George A. ; Welton, Mark L. ; Shelton, Andrew ; Kapp, Daniel S. ; Koong, Albert C. ; Goodman, Karyn A. ; Chang, Daniel T.</creator><creatorcontrib>Bazan, Jose G. ; Hara, Wendy ; Hsu, Annie ; Kunz, Pamela A. ; Ford, James ; Fisher, George A. ; Welton, Mark L. ; Shelton, Andrew ; Kapp, Daniel S. ; Koong, Albert C. ; Goodman, Karyn A. ; Chang, Daniel T.</creatorcontrib><description>BACKGROUND:
The purpose of this study was to compare outcomes in patients with anal canal squamous cell carcinoma (SCCA) who were treated with definitive chemoradiotherapy by either intensity‐modulated radiation therapy (IMRT) or conventional radiotherapy (CRT).
METHODS:
Forty‐six patients who received definitive chemoradiotherapy from January 1993 to August 2009 were included. Forty‐five patients received 5‐fluorouracil with mitomycin C (n = 39) or cisplatin (n = 6). Seventeen (37%) were treated with CRT and 29 (63%) with IMRT. The median dose was 54 Gy in both groups. Median follow‐up was 26 months (CRT) and 32 months (IMRT). T3‐T4 stage (P = .18) and lymph node‐positive disease (P = .6) were similar between groups.
RESULTS:
The CRT group required longer treatment duration (57 days vs 40 days, P < .0001), more treatment breaks (88% vs 34.5%, P = .001), and longer breaks (12 days vs 1.5 days, P < .0001) than patients treated with IMRT. Eleven (65%) patients in the CRT group experienced grade >2 nonhematologic toxicity compared with 6 (21%) patients in the IMRT group (P = .003). The 3‐year overall survival (OS), locoregional control (LRC), and progression‐free survival were 87.8%, 91.9%, and 84.2%, respectively, for the IMRT groups and 51.8%, 56.7%, and 56.7%, respectively, for the CRT group (all P < .01). On multivariate analysis, T stage, use of IMRT, and treatment duration were associated with OS, and T stage and use of IMRT were associated with LRC.
CONCLUSIONS:
The use of IMRT was associated with less toxicity, reduced need for treatment breaks, and excellent LRC and OS compared with CRT in patients with SCCA of the anal canal. Cancer 2011. © 2011 American Cancer Society.
Patients with squamous cell carcinoma of the anal canal were compared by treatment, either conventional radiotherapy (CRT) or intensity‐modulated radiotherapy (IMRT). In patients treated with IMRT, the results were improved toxicity profile, reduced frequency of treatment breaks, shorter duration of overall therapy, and excellent locoregional control and overall survival.</description><identifier>ISSN: 0008-543X</identifier><identifier>ISSN: 1097-0142</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.25901</identifier><identifier>PMID: 21287530</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>5-Fluorouracil ; anal canal ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Anus Neoplasms - drug therapy ; Anus Neoplasms - radiotherapy ; Biological and medical sciences ; Carcinoma, Squamous Cell - drug therapy ; Carcinoma, Squamous Cell - radiotherapy ; Cisplatin - administration & dosage ; Combined Modality Therapy ; conventional radiation ; Female ; Fluorouracil - administration & dosage ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; IMRT ; Male ; Medical sciences ; Middle Aged ; Mitomycin - administration & dosage ; outcomes ; Radiotherapy - methods ; Radiotherapy Dosage ; squamous cell carcinoma ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Survival Analysis ; toxicity ; Tumors</subject><ispartof>Cancer, 2011-08, Vol.117 (15), p.3342-3351</ispartof><rights>Copyright © 2011 American Cancer Society</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 American Cancer Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4271-744e17d581003d1d08f7371468022bfb73448d4e25e17b107b9aae4c105726c3</citedby><cites>FETCH-LOGICAL-c4271-744e17d581003d1d08f7371468022bfb73448d4e25e17b107b9aae4c105726c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.25901$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.25901$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,1434,27929,27930,45579,45580,46414,46838</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24363322$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21287530$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bazan, Jose G.</creatorcontrib><creatorcontrib>Hara, Wendy</creatorcontrib><creatorcontrib>Hsu, Annie</creatorcontrib><creatorcontrib>Kunz, Pamela A.</creatorcontrib><creatorcontrib>Ford, James</creatorcontrib><creatorcontrib>Fisher, George A.</creatorcontrib><creatorcontrib>Welton, Mark L.</creatorcontrib><creatorcontrib>Shelton, Andrew</creatorcontrib><creatorcontrib>Kapp, Daniel S.</creatorcontrib><creatorcontrib>Koong, Albert C.</creatorcontrib><creatorcontrib>Goodman, Karyn A.</creatorcontrib><creatorcontrib>Chang, Daniel T.</creatorcontrib><title>Intensity‐modulated radiation therapy versus conventional radiation therapy for squamous cell carcinoma of the anal canal</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND:
The purpose of this study was to compare outcomes in patients with anal canal squamous cell carcinoma (SCCA) who were treated with definitive chemoradiotherapy by either intensity‐modulated radiation therapy (IMRT) or conventional radiotherapy (CRT).
METHODS:
Forty‐six patients who received definitive chemoradiotherapy from January 1993 to August 2009 were included. Forty‐five patients received 5‐fluorouracil with mitomycin C (n = 39) or cisplatin (n = 6). Seventeen (37%) were treated with CRT and 29 (63%) with IMRT. The median dose was 54 Gy in both groups. Median follow‐up was 26 months (CRT) and 32 months (IMRT). T3‐T4 stage (P = .18) and lymph node‐positive disease (P = .6) were similar between groups.
RESULTS:
The CRT group required longer treatment duration (57 days vs 40 days, P < .0001), more treatment breaks (88% vs 34.5%, P = .001), and longer breaks (12 days vs 1.5 days, P < .0001) than patients treated with IMRT. Eleven (65%) patients in the CRT group experienced grade >2 nonhematologic toxicity compared with 6 (21%) patients in the IMRT group (P = .003). The 3‐year overall survival (OS), locoregional control (LRC), and progression‐free survival were 87.8%, 91.9%, and 84.2%, respectively, for the IMRT groups and 51.8%, 56.7%, and 56.7%, respectively, for the CRT group (all P < .01). On multivariate analysis, T stage, use of IMRT, and treatment duration were associated with OS, and T stage and use of IMRT were associated with LRC.
CONCLUSIONS:
The use of IMRT was associated with less toxicity, reduced need for treatment breaks, and excellent LRC and OS compared with CRT in patients with SCCA of the anal canal. Cancer 2011. © 2011 American Cancer Society.
Patients with squamous cell carcinoma of the anal canal were compared by treatment, either conventional radiotherapy (CRT) or intensity‐modulated radiotherapy (IMRT). In patients treated with IMRT, the results were improved toxicity profile, reduced frequency of treatment breaks, shorter duration of overall therapy, and excellent locoregional control and overall survival.</description><subject>5-Fluorouracil</subject><subject>anal canal</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Anus Neoplasms - drug therapy</subject><subject>Anus Neoplasms - radiotherapy</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Squamous Cell - drug therapy</subject><subject>Carcinoma, Squamous Cell - radiotherapy</subject><subject>Cisplatin - administration & dosage</subject><subject>Combined Modality Therapy</subject><subject>conventional radiation</subject><subject>Female</subject><subject>Fluorouracil - administration & dosage</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>IMRT</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mitomycin - administration & dosage</subject><subject>outcomes</subject><subject>Radiotherapy - methods</subject><subject>Radiotherapy Dosage</subject><subject>squamous cell carcinoma</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Survival Analysis</subject><subject>toxicity</subject><subject>Tumors</subject><issn>0008-543X</issn><issn>1097-0142</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90MtKxDAUBuAgijOObnwA6UYQoWNubTpLKV4GBgWZhbtymqZYaZOZpB0pbnwEn9EnsbWjbsRNQsiXc05-hI4JnhKM6YXU0k5pMMNkB40JngkfE0530RhjHPkBZ48jdODcc3cUNGD7aEQJjUTA8Bi9znWttCvq9uPtvTJZU0KtMs9CVkBdGO3VT8rCqvU2yrrGedLojdL9DZR_qNxYz60bqExvVVl6EqwstKnAM3nPPOhfyn49RHs5lE4dbfcJWl5fLeNbf3F_M48vF77kVBBfcK6IyIKo-yzLSIajXDBBeBhhStM8FYzzKOOKBh1LCRbpDEBxSXAgaCjZBJ0NZVfWrBvl6qQqXD8baNWNmRA-oyHhnEYdPR-otMY5q_JkZYsKbJsQnPRZJ33WyVfWHT7Z1m3SSmU_9DvcDpxuATgJZW5By8L9Os5CxijtHBncS1Gq9p-WSXwXPwzNPwGabJj0</recordid><startdate>20110801</startdate><enddate>20110801</enddate><creator>Bazan, Jose G.</creator><creator>Hara, Wendy</creator><creator>Hsu, Annie</creator><creator>Kunz, Pamela A.</creator><creator>Ford, James</creator><creator>Fisher, George A.</creator><creator>Welton, Mark L.</creator><creator>Shelton, Andrew</creator><creator>Kapp, Daniel S.</creator><creator>Koong, Albert C.</creator><creator>Goodman, Karyn A.</creator><creator>Chang, Daniel T.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Blackwell</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>7U7</scope><scope>C1K</scope></search><sort><creationdate>20110801</creationdate><title>Intensity‐modulated radiation therapy versus conventional radiation therapy for squamous cell carcinoma of the anal canal</title><author>Bazan, Jose G. ; Hara, Wendy ; Hsu, Annie ; Kunz, Pamela A. ; Ford, James ; Fisher, George A. ; Welton, Mark L. ; Shelton, Andrew ; Kapp, Daniel S. ; Koong, Albert C. ; Goodman, Karyn A. ; Chang, Daniel T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4271-744e17d581003d1d08f7371468022bfb73448d4e25e17b107b9aae4c105726c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>5-Fluorouracil</topic><topic>anal canal</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Anus Neoplasms - drug therapy</topic><topic>Anus Neoplasms - radiotherapy</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Squamous Cell - drug therapy</topic><topic>Carcinoma, Squamous Cell - radiotherapy</topic><topic>Cisplatin - administration & dosage</topic><topic>Combined Modality Therapy</topic><topic>conventional radiation</topic><topic>Female</topic><topic>Fluorouracil - administration & dosage</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>IMRT</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mitomycin - administration & dosage</topic><topic>outcomes</topic><topic>Radiotherapy - methods</topic><topic>Radiotherapy Dosage</topic><topic>squamous cell carcinoma</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Survival Analysis</topic><topic>toxicity</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bazan, Jose G.</creatorcontrib><creatorcontrib>Hara, Wendy</creatorcontrib><creatorcontrib>Hsu, Annie</creatorcontrib><creatorcontrib>Kunz, Pamela A.</creatorcontrib><creatorcontrib>Ford, James</creatorcontrib><creatorcontrib>Fisher, George A.</creatorcontrib><creatorcontrib>Welton, Mark L.</creatorcontrib><creatorcontrib>Shelton, Andrew</creatorcontrib><creatorcontrib>Kapp, Daniel S.</creatorcontrib><creatorcontrib>Koong, Albert C.</creatorcontrib><creatorcontrib>Goodman, Karyn A.</creatorcontrib><creatorcontrib>Chang, Daniel T.</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>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bazan, Jose G.</au><au>Hara, Wendy</au><au>Hsu, Annie</au><au>Kunz, Pamela A.</au><au>Ford, James</au><au>Fisher, George A.</au><au>Welton, Mark L.</au><au>Shelton, Andrew</au><au>Kapp, Daniel S.</au><au>Koong, Albert C.</au><au>Goodman, Karyn A.</au><au>Chang, Daniel T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intensity‐modulated radiation therapy versus conventional radiation therapy for squamous cell carcinoma of the anal canal</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2011-08-01</date><risdate>2011</risdate><volume>117</volume><issue>15</issue><spage>3342</spage><epage>3351</epage><pages>3342-3351</pages><issn>0008-543X</issn><issn>1097-0142</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>BACKGROUND:
The purpose of this study was to compare outcomes in patients with anal canal squamous cell carcinoma (SCCA) who were treated with definitive chemoradiotherapy by either intensity‐modulated radiation therapy (IMRT) or conventional radiotherapy (CRT).
METHODS:
Forty‐six patients who received definitive chemoradiotherapy from January 1993 to August 2009 were included. Forty‐five patients received 5‐fluorouracil with mitomycin C (n = 39) or cisplatin (n = 6). Seventeen (37%) were treated with CRT and 29 (63%) with IMRT. The median dose was 54 Gy in both groups. Median follow‐up was 26 months (CRT) and 32 months (IMRT). T3‐T4 stage (P = .18) and lymph node‐positive disease (P = .6) were similar between groups.
RESULTS:
The CRT group required longer treatment duration (57 days vs 40 days, P < .0001), more treatment breaks (88% vs 34.5%, P = .001), and longer breaks (12 days vs 1.5 days, P < .0001) than patients treated with IMRT. Eleven (65%) patients in the CRT group experienced grade >2 nonhematologic toxicity compared with 6 (21%) patients in the IMRT group (P = .003). The 3‐year overall survival (OS), locoregional control (LRC), and progression‐free survival were 87.8%, 91.9%, and 84.2%, respectively, for the IMRT groups and 51.8%, 56.7%, and 56.7%, respectively, for the CRT group (all P < .01). On multivariate analysis, T stage, use of IMRT, and treatment duration were associated with OS, and T stage and use of IMRT were associated with LRC.
CONCLUSIONS:
The use of IMRT was associated with less toxicity, reduced need for treatment breaks, and excellent LRC and OS compared with CRT in patients with SCCA of the anal canal. Cancer 2011. © 2011 American Cancer Society.
Patients with squamous cell carcinoma of the anal canal were compared by treatment, either conventional radiotherapy (CRT) or intensity‐modulated radiotherapy (IMRT). In patients treated with IMRT, the results were improved toxicity profile, reduced frequency of treatment breaks, shorter duration of overall therapy, and excellent locoregional control and overall survival.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>21287530</pmid><doi>10.1002/cncr.25901</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 5-Fluorouracil anal canal Antineoplastic Combined Chemotherapy Protocols - therapeutic use Anus Neoplasms - drug therapy Anus Neoplasms - radiotherapy Biological and medical sciences Carcinoma, Squamous Cell - drug therapy Carcinoma, Squamous Cell - radiotherapy Cisplatin - administration & dosage Combined Modality Therapy conventional radiation Female Fluorouracil - administration & dosage Gastroenterology. Liver. Pancreas. Abdomen Humans IMRT Male Medical sciences Middle Aged Mitomycin - administration & dosage outcomes Radiotherapy - methods Radiotherapy Dosage squamous cell carcinoma Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Survival Analysis toxicity Tumors |
| title | Intensity‐modulated radiation therapy versus conventional radiation therapy for squamous cell carcinoma of the anal canal |
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