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Table 3 Different SIB-IMRT schedules in treatment of anal cancer

From: Clinical experience of SIB-IMRT in anal cancer and selective literature review

Study/year Patients Mean FU (months) SIB-IMRT dose levels (prescription total dose/single dose) Number of series Range of SIB-single dose DFS LRC CFS OS Acute ≥ grade 3 toxicity
Menkarios 2007 5 * Concept: 2 dose levels (SIB): 1-2 1.5-1.8 Gy * * * * *
49.5/1.5 Gy
59.4/1.8 Gy
or
2 series (45/1.8 and 59.4/1.8 Gy)
Salama 2007 53 14.5 PTV: 32-60.9 Gy (median: 51.5 Gy) 1-2 1.65-2.0 Gy   84%/1.5y 84%/1.5y 93%/1.5y GI: 15%
Skin: 38%
ENI: 30.6-45 Gy (median: 45 Gy) Hematologic: 59%
Concept: 3 dose levels:
41.25/1.65 Gy,45/1.8, 50/2.0 (+/-boost)
Vieillot 2010 10 * Concept: 2 dose levels: 1 1.5-1.8 Gy * * * * *
49.5/1.5 Gy
59.4/1.8 Gy
Call 2011 34 22 PTV: 48.6-57.6 Gy (median: 50.4 Gy) 1 1.28-2.25 Gy 80%/3y    87%/3y Not reported
ENI: 38-45 Gy
No standard concept
Barzan 2011 29 32 Concept: 3 dose levels: 2 1.6-1.8 Gy   92/3y 91/3y 88%/3y GI: 7%
Skin: 21%
40/1.6 Gy
45/1.8 Gy Hematologic: 21%
+boost 5.4 Gy (T1/2), 9-14.4 Gy (T3/4)
Kachnic 2012 43 24 Concept: T-stage based SIB (2 dose levels) 1 1.5-1.8 Gy   95%/2y 94%/2y 92%/2y GI: 7%
Skin: 10%
T2N0: 42/1.5 Gy ENI, 50.4/1.8 Gy to PTV Hematologic: 51%
T3-4N0-3: 45/1.5 Gy ENI,
50.4/1.68 Gy to lymph nodes<3cm
54/1.8 Gy to PTV and lymph nodes>3cm
Deenen 2012 18 28 49.5/1.5 Gy ENI 1-2 1.5-1.8 Gy   83%/2y    GI: 0%,
59.4/1.8 for PTV Skin: 50%
Boost 5.4/1.8 Gy for macroscopic residual tumor after 5 weeks Hematologic: 0%
Mitchell 2013 65 19 PTV: 50-58.8 Gy (median: 54 Gy) 1 1.62-2.0 Gy 86%/2y    96%/2y GI: 9%
Skin: 17%
ENI: 40.5-50.4 Gy (median: 45 Gy) Hematologic: 3%
Concept: T-stage based SIB (2 dose levels):
T1: 50/2 Gy, 43/1.72 Gy
T2: 54/2, 45/1.67 Gy
T3/4: 58/2 , 47/1.62 Gy
Present study 25 20 45/1.8 Gy to PTV 2 1.52-2 Gy 92%/2y 92%/2y 92%/2y 88%/2y GI: 0%,
38/1.52 Gy ENI Skin: 23%
14/2 Gy boost to PTV in second series (total: 59 Gy) Hematologic: 16%
  1. *comparison of different plans, ENI = Elective node irradiation, FU = Follow-up, GI = Gastrointestinal, PTV = Planning target volume.