Chemoradiotherapy with a radiation boost for anal cancer decreases the risk for salvage abdominoperineal resection

analysis from the national cancer data base

Cristina B. Geltzeiler, Nima Nabavizadeh, Jong Kim, Kim Lu, Kevin Billingsley, Charles Thomas, Daniel Herzig, Vassiliki Tsikitis

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND: Chemoradiotherapy (CRT), the primary treatment for anal cancer, achieves complete tumor regression in most patients. Abdominoperineal resection (APR) is reserved for persistent or recurrent disease. An additional boost dose of radiation after CRT often is used to improve the response rate for advanced local disease (T3, 4, and N+). This study examines the need for salvage APR after radiation boost.

METHODS: Patients with de novo anal cancer in the National Cancer Data Base from the years 2004-2010 were analyzed. Patients with missing data points or who did not receive standard CRT were excluded. Variables included age, gender, race, primary tumor size, clinical nodal status, TNM stage, radiation boost, and APR. A logistic regression model assessing the relationship between boost radiation and APR was developed.

RESULTS: Of 1,025 patients meeting inclusion criteria, 450 patients received CRT without a radiation boost and 575 patients received CRT with a radiation boost. The two groups were similar in age, gender, race, tumor size, nodal status, and TNM stage (p values all >0.05). Significant multivariate predictors of salvage APR were tumor size, negative nodal status, and boost RT (all p  0.05). When controlling for age, tumor size, and nodal status, salvage APR is less likely to occur after boost RT (odds ratio 0.63; 95 % confidence interval 0.47, 0.85; p = 0.003).

CONCLUSIONS: When controlling for age, tumor size, and nodal status, those who received boost radiation for anal cancer were less likely to require salvage APR.

Original languageEnglish (US)
Pages (from-to)3616-3620
Number of pages5
JournalAnnals of Surgical Oncology
Volume21
Issue number11
DOIs
StatePublished - Oct 1 2014

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Anus Neoplasms
Chemoradiotherapy
Databases
Radiation
Neoplasms
Logistic Models
Odds Ratio
Confidence Intervals

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{8eed165dc6974be8a22cd61d1418e351,
title = "Chemoradiotherapy with a radiation boost for anal cancer decreases the risk for salvage abdominoperineal resection: analysis from the national cancer data base",
abstract = "BACKGROUND: Chemoradiotherapy (CRT), the primary treatment for anal cancer, achieves complete tumor regression in most patients. Abdominoperineal resection (APR) is reserved for persistent or recurrent disease. An additional boost dose of radiation after CRT often is used to improve the response rate for advanced local disease (T3, 4, and N+). This study examines the need for salvage APR after radiation boost.METHODS: Patients with de novo anal cancer in the National Cancer Data Base from the years 2004-2010 were analyzed. Patients with missing data points or who did not receive standard CRT were excluded. Variables included age, gender, race, primary tumor size, clinical nodal status, TNM stage, radiation boost, and APR. A logistic regression model assessing the relationship between boost radiation and APR was developed.RESULTS: Of 1,025 patients meeting inclusion criteria, 450 patients received CRT without a radiation boost and 575 patients received CRT with a radiation boost. The two groups were similar in age, gender, race, tumor size, nodal status, and TNM stage (p values all >0.05). Significant multivariate predictors of salvage APR were tumor size, negative nodal status, and boost RT (all p  0.05). When controlling for age, tumor size, and nodal status, salvage APR is less likely to occur after boost RT (odds ratio 0.63; 95 {\%} confidence interval 0.47, 0.85; p = 0.003).CONCLUSIONS: When controlling for age, tumor size, and nodal status, those who received boost radiation for anal cancer were less likely to require salvage APR.",
author = "Geltzeiler, {Cristina B.} and Nima Nabavizadeh and Jong Kim and Kim Lu and Kevin Billingsley and Charles Thomas and Daniel Herzig and Vassiliki Tsikitis",
year = "2014",
month = "10",
day = "1",
doi = "10.1245/s10434-014-3849-5",
language = "English (US)",
volume = "21",
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journal = "Annals of Surgical Oncology",
issn = "1068-9265",
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TY - JOUR

T1 - Chemoradiotherapy with a radiation boost for anal cancer decreases the risk for salvage abdominoperineal resection

T2 - analysis from the national cancer data base

AU - Geltzeiler, Cristina B.

AU - Nabavizadeh, Nima

AU - Kim, Jong

AU - Lu, Kim

AU - Billingsley, Kevin

AU - Thomas, Charles

AU - Herzig, Daniel

AU - Tsikitis, Vassiliki

PY - 2014/10/1

Y1 - 2014/10/1

N2 - BACKGROUND: Chemoradiotherapy (CRT), the primary treatment for anal cancer, achieves complete tumor regression in most patients. Abdominoperineal resection (APR) is reserved for persistent or recurrent disease. An additional boost dose of radiation after CRT often is used to improve the response rate for advanced local disease (T3, 4, and N+). This study examines the need for salvage APR after radiation boost.METHODS: Patients with de novo anal cancer in the National Cancer Data Base from the years 2004-2010 were analyzed. Patients with missing data points or who did not receive standard CRT were excluded. Variables included age, gender, race, primary tumor size, clinical nodal status, TNM stage, radiation boost, and APR. A logistic regression model assessing the relationship between boost radiation and APR was developed.RESULTS: Of 1,025 patients meeting inclusion criteria, 450 patients received CRT without a radiation boost and 575 patients received CRT with a radiation boost. The two groups were similar in age, gender, race, tumor size, nodal status, and TNM stage (p values all >0.05). Significant multivariate predictors of salvage APR were tumor size, negative nodal status, and boost RT (all p  0.05). When controlling for age, tumor size, and nodal status, salvage APR is less likely to occur after boost RT (odds ratio 0.63; 95 % confidence interval 0.47, 0.85; p = 0.003).CONCLUSIONS: When controlling for age, tumor size, and nodal status, those who received boost radiation for anal cancer were less likely to require salvage APR.

AB - BACKGROUND: Chemoradiotherapy (CRT), the primary treatment for anal cancer, achieves complete tumor regression in most patients. Abdominoperineal resection (APR) is reserved for persistent or recurrent disease. An additional boost dose of radiation after CRT often is used to improve the response rate for advanced local disease (T3, 4, and N+). This study examines the need for salvage APR after radiation boost.METHODS: Patients with de novo anal cancer in the National Cancer Data Base from the years 2004-2010 were analyzed. Patients with missing data points or who did not receive standard CRT were excluded. Variables included age, gender, race, primary tumor size, clinical nodal status, TNM stage, radiation boost, and APR. A logistic regression model assessing the relationship between boost radiation and APR was developed.RESULTS: Of 1,025 patients meeting inclusion criteria, 450 patients received CRT without a radiation boost and 575 patients received CRT with a radiation boost. The two groups were similar in age, gender, race, tumor size, nodal status, and TNM stage (p values all >0.05). Significant multivariate predictors of salvage APR were tumor size, negative nodal status, and boost RT (all p  0.05). When controlling for age, tumor size, and nodal status, salvage APR is less likely to occur after boost RT (odds ratio 0.63; 95 % confidence interval 0.47, 0.85; p = 0.003).CONCLUSIONS: When controlling for age, tumor size, and nodal status, those who received boost radiation for anal cancer were less likely to require salvage APR.

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SP - 3616

EP - 3620

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 11

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