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Early closure of fistula using neo-adjuvant intra-arterial chemotherapy in locally advanced anal cancer.
Cacheux, Wulfran; Koessler, Thibaud; Puppa, Giacomo; Fernandez, Eugenio; Ho, Lisa; Dietrich, Pierre-Yves; Zilli, Thomas; Allal, Abdelkarim Said; Roche, Bruno; Ris, Frederic; Roth, Arnaud.
Afiliación
  • Cacheux W; Department of Oncology, University Hospital of Geneva, Geneva, Switzerland. Electronic address: wulfran.cacheux@curie.fr.
  • Koessler T; Department of Oncology, University Hospital of Geneva, Geneva, Switzerland.
  • Puppa G; Department of Pathology, University Hospital of Geneva, Geneva, Switzerland.
  • Fernandez E; Department of Oncology, University Hospital of Geneva, Geneva, Switzerland.
  • Ho L; Department of Pathology, University Hospital of Geneva, Geneva, Switzerland.
  • Dietrich PY; Department of Oncology, University Hospital of Geneva, Geneva, Switzerland.
  • Zilli T; Department of Radiation-oncology, University Hospital of Geneva, Geneva, Switzerland.
  • Allal AS; Department of Radiation-oncology, University Hospital of Fribourg, Fribourg, Switzerland.
  • Roche B; Department of Surgery, Clinic for Visceral and Transplantation Surgery, University Hospital of Geneva, Geneva Switzerland.
  • Ris F; Department of Surgery, Clinic for Visceral and Transplantation Surgery, University Hospital of Geneva, Geneva Switzerland.
  • Roth A; Department of Oncology, University Hospital of Geneva, Geneva, Switzerland.
Dig Liver Dis ; 49(11): 1262-1266, 2017 Nov.
Article en En | MEDLINE | ID: mdl-28935189
BACKGROUND: Locally advanced anal cancer patients, especially with T4 disease and fistula, have a dismal prognosis. Neo-adjuvant intra-arterial chemotherapy before standard chemoradiation has been shown to be promising in this setting. AIMS: We are reporting results from a larger patient population. METHODS: From 2005 to 2015, 25 consecutive patients with locally advanced anal cancer, 18 of them fistulised, received intra-arterial chemotherapy. RESULTS: Twenty-two of 25 patients (88%) had T4N0-3 disease and 3 (12%) T3N3. An objective tumour response was observed in 24 of 25 patients (96%): 24 partial responses and 1 with stable disease. Fistulas' complete closure was observed in 15 of 18 patients (83.3%). Following intra-arterial chemotherapy, 23 patients underwent chemoradiation. Twenty-one of 25 patients (84%) had a complete remission 6 months after treatment completion. Amongst 22 patients followed for 3 or more years, 18 of them (81%) are colostomy free at 3 years. Five-year overall survival is 75%. Most frequent grade 3-4 toxicity of IAC was neutropenia (25%). CONCLUSIONS: Neo-adjuvant intra-arterial chemotherapy combined to chemoradiation resulted in a high rate of fistulas closure and long-term control of locally advanced anal cancer. This interesting approach in the treatment of fistulised anal cancer, needs a prospective study before being considered a new standard strategy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Ano / Protocolos de Quimioterapia Combinada Antineoplásica / Fístula Rectal Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Dig Liver Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2017 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Ano / Protocolos de Quimioterapia Combinada Antineoplásica / Fístula Rectal Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Dig Liver Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2017 Tipo del documento: Article Pais de publicación: Países Bajos