Vaginal Sparing Using a Mold in Anal Cancer Female Patients Treated With Intensity Modulated Radiation Therapy: A Dosimetric Feasibility Study

Abstract

days was delivered (3 pts received 15 Gy in 3 fractions) after post-implant CT-scan planning. Dose-volume adaptation was manually achieved using graphical optimization. Dosimetric data and clinical outcome were retrospectively analyzed. Due to short follow-up, patients treated in 2013 (4 pts) were excluded from the clinical outcome analysis. Toxicities were graded using the CTC v4.0. Results: Dosimetric data are reported in Table. Median follow-up was 25.4 months (range, 1.5-81.6 months). Male/female ratio was 0.59 with a median age of 63 years (range, 34-84 years). Median dose of EBRT was 45 Gy (range, 43.20-52 Gy), median overall treatment time was 63 days (range, 5-249 days). Two-year actuarial survival rates were 84% (SE 8%) for local relapse free survival, 94% (SE 5%) for colostomy-free survival, 76% (SE 10%) for metastatic free survival. The 2.5-years actuarial overall survival rate was 92% (SE 7%). Acute toxicities following HDB (<2 months) were frequent but not severe: urinary (37% of grade 1 [G1], no G2, G3 or G4), anal (40.7% G1), cutaneous (3.7% G1). Late toxicities were: G1 (48.1%) and G2 (22.2%), 1 patient presented G3 toxicity with anal canal necrosis. Three patients (11.1%) underwent a colostomy including 1 pt with sphincter amputation. Conclusions: HDB for anal canal carcinoma represents a feasible technique compared to low or pulsed-dose rate brachytherapy. This technique remains an excellent approach to precisely boost the tumor in reducing the overall treatment time while high-dose rate is more and more used in the frame of brachytherapy. Author Disclosure: A. Falk: None. A. Claren: None. K. Benezery: None. A. Leysalle: None. J. Feuillade: None. M. Chand: None. E. Francois: None. J. Hannoun-Levi: None.