Can we omit prophylactic inguinal nodal irradiation in anal cancer patients?
Identifieur interne : 002053 ( Main/Exploration ); précédent : 002052; suivant : 002054Can we omit prophylactic inguinal nodal irradiation in anal cancer patients?
Auteurs : Hakyoung Kim [Corée du Sud] ; Hee Chul Park [Corée du Sud] ; Jeong Il Yu [Corée du Sud] ; Doo Ho Choi [Corée du Sud] ; Yong Chan Ahn [Corée du Sud] ; Seung Tae Kim [Corée du Sud] ; Joon Oh Park [Corée du Sud] ; Young Suk Park [Corée du Sud] ; Hee Cheol Kim [Corée du Sud]Source :
- Radiation Oncology Journal [ 2234-1900 ] ; 2015.
Abstract
To evaluate the appropriateness of prophylactic inguinal nodal irradiation (PINI), we analyzed patterns of failure in anal cancer patients who were inguinal node-negative at presentation and did not receive PINI.
We retrospectively reviewed the records of 33 anal cancer patients treated by definitive concurrent chemoradiation therapy (CCRT) between 1994 and 2013. Radiotherapy consisted of a total dose of 44-45 Gy (22-25 fractions in 5 weeks) on the whole pelvis, anus, and perineum. Except inguinal lymphadenopathy was present at initial diagnosis, the entire inguinal chain was not included in the radiation field. In other words, there was no PINI.
The median follow-up duration was 50 months (range, 4 to 218 months). Median survival and progression-free survival (PFS) were 57 months (range, 10 to 218 months) and 50 months (range, 4 to 218 months), respectively. Among the survival, the median follow-up duration was 51 months (range, 12 to 218 months). The 5-year overall survival and PFS rates were 93.4% and 88.8%, respectively. Although none of the patients received inguinal node irradiation for prophylactic purposes, there was no inguinal recurrence.
Treatment of anal cancer by omitting PINI might be considered in selected patients with clinically uninvolved inguinal nodes.
Url:
DOI: 10.3857/roj.2015.33.2.83
PubMed: 26157677
PubMed Central: 4493432
Affiliations:
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Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Yu, Jeong Il" sort="Yu, Jeong Il" uniqKey="Yu J" first="Jeong Il" last="Yu">Jeong Il Yu</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea><placeName><settlement 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type="wicri:Area/Main/Curation">002053</idno><idno type="wicri:Area/Main/Exploration">002053</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Can we omit prophylactic inguinal nodal irradiation in anal cancer patients?</title><author><name sortKey="Kim, Hakyoung" sort="Kim, Hakyoung" uniqKey="Kim H" first="Hakyoung" last="Kim">Hakyoung Kim</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Park, Hee Chul" sort="Park, Hee Chul" uniqKey="Park H" first="Hee Chul" last="Park">Hee Chul Park</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Yu, Jeong Il" sort="Yu, Jeong Il" uniqKey="Yu J" first="Jeong Il" last="Yu">Jeong Il Yu</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Choi, Doo Ho" sort="Choi, Doo Ho" uniqKey="Choi D" first="Doo Ho" last="Choi">Doo Ho Choi</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Ahn, Yong Chan" sort="Ahn, Yong Chan" uniqKey="Ahn Y" first="Yong Chan" last="Ahn">Yong Chan Ahn</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Kim, Seung Tae" sort="Kim, Seung Tae" uniqKey="Kim S" first="Seung Tae" last="Kim">Seung Tae Kim</name><affiliation wicri:level="3"><nlm:aff id="A2">Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Park, Joon Oh" sort="Park, Joon Oh" uniqKey="Park J" first="Joon Oh" last="Park">Joon Oh Park</name><affiliation wicri:level="3"><nlm:aff id="A2">Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Park, Young Suk" sort="Park, Young Suk" uniqKey="Park Y" first="Young Suk" last="Park">Young Suk Park</name><affiliation wicri:level="3"><nlm:aff id="A2">Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Kim, Hee Cheol" sort="Kim, Hee Cheol" uniqKey="Kim H" first="Hee Cheol" last="Kim">Hee Cheol Kim</name><affiliation wicri:level="3"><nlm:aff id="A3">Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author></analytic><series><title level="j">Radiation Oncology Journal</title><idno type="ISSN">2234-1900</idno><idno type="eISSN">2234-3164</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>To evaluate the appropriateness of prophylactic inguinal nodal irradiation (PINI), we analyzed patterns of failure in anal cancer patients who were inguinal node-negative at presentation and did not receive PINI.</p></sec><sec><title>Materials and Methods</title><p>We retrospectively reviewed the records of 33 anal cancer patients treated by definitive concurrent chemoradiation therapy (CCRT) between 1994 and 2013. Radiotherapy consisted of a total dose of 44-45 Gy (22-25 fractions in 5 weeks) on the whole pelvis, anus, and perineum. Except inguinal lymphadenopathy was present at initial diagnosis, the entire inguinal chain was not included in the radiation field. In other words, there was no PINI.</p></sec><sec><title>Results</title><p>The median follow-up duration was 50 months (range, 4 to 218 months). Median survival and progression-free survival (PFS) were 57 months (range, 10 to 218 months) and 50 months (range, 4 to 218 months), respectively. Among the survival, the median follow-up duration was 51 months (range, 12 to 218 months). The 5-year overall survival and PFS rates were 93.4% and 88.8%, respectively. Although none of the patients received inguinal node irradiation for prophylactic purposes, there was no inguinal recurrence.</p></sec><sec><title>Conclusion</title><p>Treatment of anal cancer by omitting PINI might be considered in selected patients with clinically uninvolved inguinal nodes.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Whiteford, Mh" uniqKey="Whiteford M">MH Whiteford</name></author><author><name sortKey="Stevens, Kr" uniqKey="Stevens K">KR Stevens</name></author><author><name sortKey="Oh, S" uniqKey="Oh S">S Oh</name></author><author><name sortKey="Deveney, Ke" uniqKey="Deveney K">KE Deveney</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ryan, Dp" uniqKey="Ryan D">DP Ryan</name></author><author><name sortKey="Compton, Cc" uniqKey="Compton C">CC Compton</name></author><author><name sortKey="Mayer, Rj" uniqKey="Mayer R">RJ 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last="Choi">Doo Ho Choi</name><name sortKey="Kim, Hee Cheol" sort="Kim, Hee Cheol" uniqKey="Kim H" first="Hee Cheol" last="Kim">Hee Cheol Kim</name><name sortKey="Kim, Seung Tae" sort="Kim, Seung Tae" uniqKey="Kim S" first="Seung Tae" last="Kim">Seung Tae Kim</name><name sortKey="Park, Hee Chul" sort="Park, Hee Chul" uniqKey="Park H" first="Hee Chul" last="Park">Hee Chul Park</name><name sortKey="Park, Joon Oh" sort="Park, Joon Oh" uniqKey="Park J" first="Joon Oh" last="Park">Joon Oh Park</name><name sortKey="Park, Young Suk" sort="Park, Young Suk" uniqKey="Park Y" first="Young Suk" last="Park">Young Suk Park</name><name sortKey="Yu, Jeong Il" sort="Yu, Jeong Il" uniqKey="Yu J" first="Jeong Il" last="Yu">Jeong Il Yu</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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