A RETROSPECTIVE ANALYSIS OF ANAL CANAL CARCINOMA TREATED WITH CONCURRENT CHEMORADIATION


Dr. Sivasubramaniam
MMC

PURPOSE: To analyse the stage at presentation, eligibility and tolerability of concurrent chemoradiation and response rate along with overall survival in patients with squamous cell carcinoma (SCC) of anal canal treated between january 2013 and april 2017.

MATERIALS AND METHODS: 33 patients with squamous cell carcinoma of anal canal were analysed retrospectively. Among them 27 patients were treated radically with concurrent chemoradiation with stage (T1-4, N1-3, M0). Concurrent chemotherapy given was 5 fluorouracil 750mg/m² day 1-3 of radiotherapy and cisplatin 75mg/m² day1 repeated every 21 days till completion of radiotherapy. Patients were initially given a radiation dose of 45Gy in 1.8 Gy per fraction. Patients with T3 disease and residual disease also received a boost of 10-15 Gy of radiation. Among the 27 patients 2 patients defaulted treatment. Of the total 33 patients, 2 patients underwent upfront surgery (APR) and among them one patient received
adjuvant chemoradiation. 4 patients were fit only for palliative treatment, among which 2 patients had metastatic disease. Progression free survival (PFS) and overall survival (OS) for radically treated patients were analysed using Kaplan-Meier method separately.

RESULTS: Median age of the patient was 60 years with a male to female ratio of 1.3:2. Most of the patients were ECOG-PS 2 (60.6%). Most common grade was moderately differentiated SCC. 60.6% of the patients had T3 disease and 33.3% of patients had N1 disease at presentation. 12.1% (4 patients) were HIV positive and were on ART during treatment. 72% (18 patients) had grade1-2 diarrhoea and 20% (5 patients) had grade3-4 diarrhoea during the treatment course. Only 1 patient (4%) had grade 2 anaemia. Median follow up was 34 months (range 10 to 75 months). Median 5 year OS was 52.7 months and PFS was 47.9 months.


CONCLUSION: Concurrent chemoradiation resulted in PFS and OS benefits (which were comparable with historicalcohorts) profile with an acceptable toxicity in section of the anal kanal.

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