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. 2017 Feb 6;2(2):110-117.
doi: 10.1016/j.adro.2017.01.009. eCollection Apr-Jun 2017.

Long-term Outcomes and Toxicities of a Large Cohort of Anal Cancer Patients Treated With Dose-Painted IMRT Per RTOG 0529

Free PMC article

Long-term Outcomes and Toxicities of a Large Cohort of Anal Cancer Patients Treated With Dose-Painted IMRT Per RTOG 0529

Devarati Mitra et al. Adv Radiat Oncol. .
Free PMC article


Purpose: To describe the outcomes and toxicities of the largest cohort to date of patients with anal squamous cell carcinoma uniformly treated with concurrent chemoradiation using dose-painted intensity modulated radiation therapy (DP-IMRT) according to RTOG 0529.

Methods and materials: We identified 99 eligible patients with anal cancer who were treated at our institution with definitive chemoradiation using DP-IMRT between 2005 and 2015 per RTOG 0529 dosing guidelines. Primary study endpoints included event-free survival (defined as recurrence, colostomy, or death) and overall survival. Secondary endpoints were treatment duration and acute and late toxicity.

Results: At a median follow-up of 49 months (range, 2-114 months), 92% of patients had a clinical complete response. Fifteen percent underwent colostomy, including 4 pretreatment colostomies, 6 planned abdominoperineal resections (APRs), 4 salvage APRs, and 1 APR for treatment-related complications. Thirteen patients developed local recurrence, of whom 6 developed synchronous metastatic disease. The 4-year overall survival was 85.8%, and 4-year event-free survival was 75.5%. Median treatment duration was 43 days (range, 10-68 days). The overall rate of non-hematologic grade 3+ acute and grade 2+ late toxicities was 20% and 15%, respectively.

Conclusions: Long-term outcomes and tolerability were excellent In the largest cohort to date of patients with anal cancer who received DP-IMRT prescribed per RTOG 0529.


Figure 1
Figure 1
(A) Overall survival and (B) event-free survival (defined as absence of death, colostomy, or recurrence) for patients receiving dose-painted intensity modulated radiation therapy at our institution, as described in RTOG 0529.

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