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% |