Definitive Chemoradiotherapy for Anal Carcinoma: Long-Term Results Based on Consistent Time-to-Event Endpoints

Abstract

Aim: To report the long-term results after definitive chemoradiotherapy (CRT) for anal carcinoma, using consistent time-to-event endpoints.

Methods and materials: Anal carcinoma patient charts were reviewed. All patients received definitive CRT. Overall survival (OS), local failure-free survival (LFFS), locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), and anal dysfunction-free survival (ADFS) were estimated.

Results: In total, 65 patients were included. CRT was well tolerated, with only 24.6% grade ≥3 acute toxicity. Overall, the 5-year OS, LFFS, LRFFS, and DMFS were 75.3, 60.2, 74.2, and 66.2%, respectively. Early complete clinical response and tumor stage at diagnosis were the strongest predictors of OS (p = 0.04) and local failure (p = 0.03), respectively.

Conclusions: In the treatment of anal cancers, excellent ADFS and OS, and valid LFFS, LRFFS, and DMFS can be achieved with definitive CRT. Adequacy of time-to-event endpoints is paramount.

Keywords: Anal carcinoma; Chemoradiotherapy; Quality of life; Survival; Toxicity.