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Table 1 Patient, tumor, and treatment characteristics

From: Patterns of recurrence in anal cancer: a detailed analysis

 

n (%)

Age at diagnosis (years)

 Mean; SD

64.4; 9.3

Female gender

137 (80.6)

Staging

 CT

170 (100)

 PET

165 (97.1)

 MRI

156 (91.8)

Tumor localization

 Anal canal

32 (18.8)

 Anal canal + rectuma

48 (28.2)

 Anal canal + perianalb

52 (30.6)

 Anal canal + rectum + perianal

30 (17.6)

 Perianal

5 (2.9)

 Rectum

3 (1.8)

T stagec

 1.

14 (8.2)

 2.

83 (48.8)

 3.

35 (20.6)

 4.

38 (22.4)

Lymph node metastasis, N + c

88 (51.8)

Site of lymph node metastasis

 Inguinal

65 (38.2)

 Internal iliac

20 (11.8)

 External iliac

21 (12.4)

 Mesorectald or presacral

33 (19.4)

 Common iliac or para-aortic

4 (2.4)

Radiation dose, primary tumor

 Mean; SD (Gy)

59.0; 2.8

 52–55 Gy

28

 56–60 Gy

125

 61–64 Gy

17

Radiation dose, lymph node metastasis

 Mean; SD (Gy)

57.4; 4.8

 40–50 Gy

16

 51–55 Gy

10

 56–60 Gy

58

 61–64 Gy

4

Radiation dose, elective CTV

 Mean; SD (Gy)

44.7; 4.9

 40–42 Gy

38

 46 Gy

120

 48.6 Gy

12

Margin from GTVT to CTVT

  < 1,5 cm

9 (4.7)

 1,5 cm

132 (77.6)

  > 1,5 cm

29 (17.1)

Margin from GTVN to CTVNe

  ≤ 0,5 cm

38 (45.2)

 0,6–0,9 cm

25 (29.8)

  ≥ 1,0 cm

21 (25.0)

Included in elective CTVf

 Inguinal

167 (98.2)

 Internal iliac

168 (98.8)

 External iliac

157 (92.4)

 Presacral

168 (98.8)

 Mesorectal

169 (99.4)

 Ischiorectal fossa

154 (90.6)

 Sacral hollows

13 (7.6)

Superior border of elective CTV

  > 2 cm above iliac bifurcationg

8 (4.7)h

 Within +/− 2 cm from iliac bifurcation

114 (67.1)

 2,1–4 cm below iliac bifurcation

33 (19.4)

  > 4 cm below iliac bifurcation

15 (8.8)

Radiation treatment time

 Mean; SD

41.5; 4.4

 Median; range

42.0; 35–69

Radiation technique

 IMRT

14 (8.2)

 Tomotherapy

36 (21.2)

 VMAT

120 (70.6)

Induction chemotherapy

10 (5.9)i

Concomitant chemotherapy

152 (89.4)

 2 cycles

103j

 1 cycle

49k

  + cetuximabl

8

 Dose reduction of chemotherapy

31

Stoma before start of radiotherapy

23 (13.5%)m

Salvage surgery

 Indication locoregional recurrence

16 (9.4%)

 Indication severe toxicity

5 (2.9%)

  1. Abbreviations: SD Standard deviation, CT Computed tomography, PET Positron emission tomography, MRI Magnetic resonance imaging, CTV Clinical target volume, GTV Gross target volume, IMRT Intensity modulated radiation therapy, VMAT Volumetric modulated arc therapy, FUMI Fluorouracil + mitomycin C
  2. arectum = tumor extension above puborectalis muscle
  3. bperianal = tumor extension outside the anal verge
  4. cTNM8
  5. dSuperior rectal included in mesorectal
  6. eLymph node metastases were not boosted in 4 patients
  7. f> 80% of region covered in elective CTV to count as “included”
  8. gCommon iliac artery into external and internal iliac arteries
  9. hIncluding 4 patients with common iliac or para-aortic metastasis
  10. i9 of 10 also received concomitant chemotherapy
  11. jFluorouracil + mitomycin C (n = 102) or platinum based
  12. kFluorouracil + mitomycin C (n = 41) or platinum based
  13. lProspective Phase I study (Leon et al, Eur J Cancer. 2015;51:2740–6)
  14. m4 of 23 eventually reversed