Chemoradiotherapy for squamous cell carcinoma of the anal canal: Comparison of one versus two cycles XXXX .

@entity1 @entity137 @entity3012 @entity5 @entity1138 @entity1139 @entity1349 @entity1487
BACKGROUND AND PURPOSE: Concurrent chemoradiotherapy with @entity1487 ( @entity1487 ) and @entity1138 ( @entity1139 ) is standard treatment for @entity5 . Randomized clinical trials in Europe have used 1 cycle @entity1139 , while North American studies use 2 cycles. We compared treatment outcomes between @entity1 treated with either 1 or 2 cycles of concurrent @entity1139 . MATERIAL AND METHODS: 217 consecutive @entity1 were treated definitively with chemoradiation from 2004 to 2012 in an integrated health system. Concurrent chemotherapy regimen depended on individual practice, and consisted of 2 cycles @entity1487 (1000 mg/m(2)/day on days 1-4 and 29-32), along with @entity1139 (10-15 mg/m(2)), given on either day 1 alone (n = 154), or days 1 and 29 (n = 63). Outcomes included progression-free (PFS), @entity5 (CSS), overall ( @entity3012 ), and @entity1349 ( @entity1349 ), as well as @entity137 criteria. RESULTS: Median age 60 years, 70% female, 52% T3-T4, and 40% node-positive. Median follow-up 26 months. At 2 years, outcomes were: PFS 80%, CSS 89%, @entity3012 86%, and @entity1349 88%. There was no difference in PFS (HR 0.85, 95% CI 0.37-1.92), CSS (HR 0.32, 95% CI 0.07-1.42), @entity3012 (HR 0.67, 95% CI 0.25-1.83), or @entity1349 (HR 0.91, 95% CI 0.31-2.67) between the MMC1 and MMC2 groups. Stage and male gender were predictive of worse outcomes. Acute grade     2 @entity137 were worse in the MMC2 group. There were 3 treatment-related deaths, all in the MMC2 group. CONCLUSIONS: This study suggests that MMC1 is efficacious and may be an alternative to MMC2 in @entity1 with @entity5 treated with definitive chemoradiation, with the potential for less acute treatment-related @entity137 . Randomized trials comparing these two regimens could be considered.
