방사선종양학

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  • [Anticancer Res.] 항문 편평상피암에서의 방사선치료: 다기관 후향적 연구 Radiation Therapy for Anal Squamous Cell Carcinoma: A Retrospective Multicenter Study.

    이화의대, KIRAMS / 고현강, 김규보*, 김미숙*

  • 출처
    Anticancer Res.
  • 등재일
    2018 Dec
  • 저널이슈번호
    38(12):6931-6938. doi: 10.21873/anticanres.13071.
  • 내용

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    Abstract
    AIM:
    To analyze the treatment outcomes, patterns of failures and prognostic factors for patients with anal cancer treated with radiotherapy (RT).

    MATERIALS AND METHODS:
    Between January 2000 and December 2015, 83 patients with anal squamous cell carcinoma were treated with definitive RT. The median RT dose applied to the primary carcinoma site was 55 (range=45-64) Gy. Seventy-six patients (91.6%) received concurrent chemotherapy, and the most common regimen was 5-fluorouracil plus mitomycin C.

    RESULTS:
    The median age of patients was 64 (range=36-86) years, and there were 21 males and 62 females. The overall complete remission rate was 89.2%. The median duration of follow-up was 51 (range=3-173) months. The actuarial 5-year overall, progression-free survival (PFS), locoregional progression-free, and distant metastasis-free survival rates were 85.0%, 70.4%, 78.2%, and 82.6%, respectively. On multivariate analysis, eventual treatment response was the only prognostic factor for overall (p=0.023) and progression-free (p<0.001) survival. Age (p=0.013) and eventual treatment response (p<0.001) were significantly associated with locoregional progression-free survival. Initial treatment response, lymph node involvement and RT technique significantly affected distant metastasis-free survival (p=0.016, 0.048 and 0.002, respectively).

    CONCLUSION:
    RT, mainly with concurrent chemotherapy, showed acceptable treatment outcomes and safe toxicity profiles.

     


    Author information

    Koh HK1, Kim K2, Jang WI3, Song CH4, Chang AR5, Park HJ6, Kim KS7, Chang JH8, Kim MS9.
    1
    Department of Radiation Oncology, Konkuk University Medical Center, Seoul, Republic of Korea.
    2
    Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Republic of Korea kyubokim.ro@gmail.com mskim@kirams.re.kr.
    3
    Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea.
    4
    Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
    5
    Department of Radiation Oncology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
    6
    Department of Radiation Oncology, Hanyang University College of Medicine, Seoul, Republic of Korea.
    7
    Department of Radiation Oncology, Dongnam Institute of Radiological and Medical Sciences, Busan, Republic of Korea.
    8
    Department of Radiation Oncology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
    9
    Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea kyubokim.ro@gmail.com mskim@kirams.re.kr.

  • 키워드
    Anal cancer; pattern of failure; prognostic factor; radiotherapy; treatment outcome
  • 연구소개
    비교적 드문 항문암에서 근치적 방사선치료의 성적을 국내 8개 기관의 자료를 모아 분석한 논문입니다. 고령이거나 조기 병변인 경우를 제외하고, 대부분 (91.6%)에서 동시항암화학방사선치료를 시행받았고, 항암화학요법으로는 82.9%에서 5-fluorouracil + mitomycin-C가 적용되었으며, 방사선치료 종료 후 추가적인 항암화학요법이 적용된 경우는 10.5%에 불과하여 대부분의 환자들이 표준요법에 따라 치료받았음을 알 수 있었습니다. 시기에 따라 방사선치료기법도 2차원 방사선치료에서 3차원 입체조형방사선치료와 세기조절 방사선치료로 발전하였고, 발전된 치료기법이 무전이생존율에서 유의한 예후인자로 분석되었으며, 3도 이상의 급성 피부부작용도 줄어듦이 관찰되었습니다.
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