eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
Current Issue Archive Supplements Articles in Press Journal Information Aims and Scope Editorial Office Editorial Board Register as Author Register as Reviewer Instructions for Authors Abstracting and indexing Subscription Advertising Information Links
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
Search
3/2021
vol. 13
 
Share:
Send email
Share:
abstract:
Original paper

Pulse-dose-rate interstitial brachytherapy in anal squamous cell carcinoma: clinical outcomes and patients’ health quality perception

Rémi Bourdais
1
,
Samir Achkar
1
,
Sophie Espenel
1
,
Sophie Bockel
1
,
Laetitia Chauffert-Yvart
2
,
Florence Ravet de Mellis
1
,
Minh-Hanh Ta
1
,
Wassila Boukhelif
3
,
Jérôme Durand-Labrunie
1
,
Pascal Burtin
1
,
Christine Haie-Meder
1
,
Eric Deutsch
1, 4
,
Cyrus Chargari
1, 4, 5

  1. Brachytherapy Unit, Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
  2. Medical Oncology Department, Henri Mondor Hospital, AP-HP, Creteil, France
  3. Radiation Oncology Department, Centre Hospitalier Intercommunal, Creteil, France
  4. INSERM1030 Radiothérapie Moléculaire et Innovations Thérapeutiques, Université Paris-Saclay, Villejuif, France
  5. French Military Health Academy, Ecole du Val-de-Grâce, Paris, France
J Contemp Brachytherapy 2021; 13, 3: 263–272
DOI: https://doi.org/10.5114/jcb.2021.106247
Online publish date: 2021/05/18
View full text Get citation
 
Introduction
To examine clinical outcomes and quality of life of patients with anal squamous cell carcinoma treated with interstitial pulsed-dose-rate brachytherapy (PDR-BT) with a boost to residual tumor after external radiotherapy.

Material and methods
Medical records of patients receiving a brachytherapy boost after radiotherapy for anal squamous cell carcinoma in our Institute between 2008 and 2019 were retrospectively reviewed. After receiving pelvic irradiation ± concurrent chemotherapy, patients received PDR-BT boost to residual tumor, in order to deliver a minimal total dose of 60 Gy. Patients’ outcomes were analyzed, with primary focus on local control, sphincter preservation, morbidity, and quality of life.

Results
A total of 42 patients were identified, included 24, 13, and 5 patients with I, II, and III tumor stages, respectively. Median brachytherapy (BT) dose was 20 Gy (range, 10-30 Gy). Median dose per pulse was 42 cGy (range, 37.5-50 cGy). With median follow-up of 60.4 months (range, 5.4-127.4 months), estimated local control and colostomy-free survival rates at 5 years were both 88.7% (95% CI: 67.4-96.4%). The largest axis of residual lesion after external beam radiation therapy (EBRT) and poor tumor shrinkage were associated with more frequent relapses (p = 0.02 and p = 0.007, respectively). Out of 40 patients with more than 6 months follow-up, only one experienced severe delayed toxicity (fecal incontinence). Health quality perception was very good or good in 20 of 22 (91%) patients, according to their replies of quality-of-life surveys. A total dose ≥ 63 Gy was associated with higher number of anorectal grade 1+ toxicities (n = 1.5 vs. n = 0.61, p = 0.02).

Conclusions
In this cohort of 42 patients with mainly I and II tumor stages, PDR-BT boost allowed for local control in 88.7% of patients, with only one grade 3 anorectal toxicity.

keywords:

anal squamous cell carcinoma, brachytherapy, pulsed-dose-rate, local control

  
Termedia
About us Contact
Copyright notice Privacy policy Advertising policy Contact us
Quick links
Journals Books eBooks Events
© 2024 Termedia Sp. z o.o.
Developed by Bentus.