Intensity-modulated radiation therapy versus conventional radiation therapy for XXXX of the anal canal.

@entity1 @entity137 @entity1138 @entity957 @entity900 @entity1349 @entity1487
BACKGROUND: The purpose of this study was to compare outcomes in @entity1 with @entity957 ( @entity957 ) who were treated with definitive chemoradiotherapy by either intensity-modulated radiation therapy (IMRT) or conventional radiotherapy (CRT). METHODS: Forty-six @entity1 who received definitive chemoradiotherapy from January 1993 to August 2009 were included. Forty-five @entity1 received @entity1487 with @entity1138 (n = 39) or @entity900 (n = 6). Seventeen (37%) were treated with CRT and 29 (63%) with IMRT. The median dose was 54 Gy in both groups. Median follow-up was 26 months (CRT) and 32 months (IMRT). T3-T4 stage (P = .18) and lymph node-positive disease (P = .6) were similar between groups. RESULTS: The CRT group required longer treatment duration (57 days vs 40 days, P < .0001), more treatment breaks (88% vs 34.5%, P = .001), and longer breaks (12 days vs 1.5 days, P < .0001) than @entity1 treated with IMRT. Eleven (65%) @entity1 in the CRT group experienced grade >2 nonhematologic @entity137 compared with 6 (21%) @entity1 in the IMRT group (P = .003). The 3-year @entity1349 ( @entity1349 ), locoregional control (LRC), and progression-free survival were 87.8%, 91.9%, and 84.2%, respectively, for the IMRT groups and 51.8%, 56.7%, and 56.7%, respectively, for the CRT group (all P < .01). On multivariate analysis, T stage, use of IMRT, and treatment duration were associated with @entity1349 , and T stage and use of IMRT were associated with LRC. CONCLUSIONS: The use of IMRT was associated with less @entity137 , reduced need for treatment breaks, and excellent LRC and @entity1349 compared with CRT in @entity1 with @entity957 of the anal canal.
