scholarly journals A Definitive IMRT-SIB with Concomitant Chemotherapy for Synchronous Locally Advanced Anal Canal Cancer and Prostate Cancer

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Tubin Slavisa ◽  
Raunik Wolfgang
Keyword(s):  
Prostate Cancer ◽  
Anal Canal ◽  
Primary Tumour ◽  
Locally Advanced ◽  
Point Of View ◽  
Anal Canal Cancer ◽  
Concomitant Chemotherapy ◽  
Anal Canal Carcinoma ◽  
Genitourinary Toxicity ◽  
Patient Reported

Currently, there are no specific recommendations regarding the management of the synchronous tumours due to the lack of either specific guidelines or individuals’ clinical experiences relative to these clinical situations. In the presence of a locally advanced double primary tumour and with the lymph node metastases in addition, from the radiotherapeutical point of view, it must be challenging to manage this complicated situation that requires a more delicate treatment planning, due to higher doses prescribed to greater volumes concomitantly with the chemotherapy. A 68-year-old Caucasian male with a synchronous intermediate-risk prostate adenocarcinoma and locally advanced anal canal carcinoma underwent IMRT-SIB with concomitant chemotherapy at our institute. Two years after the treatment, the restaging CT and MRI scan showed no evidence of the disease and the patient reported no significant gastrointestinal or genitourinary toxicity. Our experience is unique, since it is the first report on using the IMRT-SIB technique simultaneously with chemotherapy in the management of the synchronous prostate and anal canal carcinomas. Therefore, we find it important to provide the current literature with the results from our experience which show good feasibility, efficacy, and tolerability of the definitive concomitant IMRT-SIB-chemotherapy for the synchronous anal canal cancer and prostate cancer.

scholarly journals Carcinoma of the anal canal

2011 ◽  
Vol 3 (1) ◽  
pp. 27
Author(s):  
David T. Marshall ◽  
Charles R. Thomas Jr
Keyword(s):  
Anal Canal ◽  
Locally Advanced ◽  
The United States ◽  
Sphincter Preservation ◽  
Tumor Control ◽  
Anal Canal Cancer ◽  
Permanent Colostomy ◽  
Anti Cancer ◽  
Treatment Paradigm ◽  
Technological Developments

There are around 5,000 new cases of anal canal cancer each year in the United States. It is of particular risk in HIV-positive populations. Many cases are related to persistent infection with human papillomavirus (HPV). The treatment of anal cancer has progressed from abdominoperineal resection mandating permanent colostomy in the 1940s through the 1970s to modern chemoradiation with sphincter preservation in around 80% of patients, even with locally advanced disease. The evolution of the treatment paradigm of this disease is a model for the treatment of malignant disease with organ preservation. Multiple randomized trials have been conducted to guide this evolution. Technological developments in the delivery of radiotherapy and anti-cancer pharmaceuticals harbor hope for further improvements in outcomes with possible reductions in toxicity and increases in tumor control. Perhaps most inspiring is the recent development of HPV vaccines that

Health-related quality-of-life (HRQoL) analysis from a randomized phase II trial of androgen signaling inhibitors with or without androgen deprivation therapy (ADT) for castration-sensitive prostate cancer: LACOG 0415.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 64-64
Author(s):  
Andrey Soares ◽  
Diogo Assed Bastos ◽  
Fabio A. B. Schutz ◽  
Eduardo Cronemberger ◽  
Murilo Luz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Locally Advanced ◽  
Patient Reported Outcome ◽  
Abiraterone Acetate ◽  
Outcome Data ◽  
Rank Test ◽  
Emotional Wellbeing ◽  
Patient Reported ◽  
Related Quality

64 Background: LACOG0415 is a 3-arm randomized trial evaluating ADT with abiraterone acetate plus prednisone (ADT+AAP), apalutamide alone (APA) or apalutamide with AAP (APA+AAP) for patients with locally-advanced, high-risk biochemical recurrence or metastatic castration-sensitive prostate cancer (ASCO 2020). In this trial, ADT+AAP and APA+AAP achieved the primary endpoint of percentage of patients with PSA ≤ 0.2 ng/mL at week 25. Apalutamide alone showed a high PSA decline > 50% rate, but did not achieve the pre-specified PSA threshold. Here we report patient-reported outcome data using Functional Assessment of Cancer Therapy-Prostate (FACT-P). Methods: HRQoL was measured in the overall population using the FACT-P questionnaire, comprising 5 subscales: physical wellbeing (PWB), functional wellbeing (FWB), emotional wellbeing (EWB), social/family wellbeing (SFWB), and prostate cancer subscale (PCS). Scores for each patient were measured at baseline and every four weeks until week 25. Questionnaire completion was defined as ≥ 1 question answered at an assessment time point. Analysis of HRQoL change from baseline and deterioration included only patients with baseline and ≥ 1 postbaseline score. Differences greater than 10-points in FACT-P total score and differences greater than 3-points in PWB, FWB, EWB, SFWB, and PCS scores were considered clinically significant. The time-to-event endpoint was estimated by Kaplan-Meier method and compared by stratified log-rank test. Results: 128 patients were included in LACOG0415 trial and 122 of them completed the HRQoL assessments (ranging from 95.3% at baseline to 79.7% at week 25). FACT-P and all subscales scores were similar for all three arms at baseline. There were no meaningful differences in FACT-P scores at baseline and at week 25 between the 3 arms. The subscales scores also showed no statistically differences at baseline and at week 25. Time to FACT-P deterioration did not show any statistically difference between three arms ( P=0.3371). Conclusions: ADT free alternatives with APA alone or APA+AAP did not show meaningful differences in HRQoL in patients with advanced castration-sensitive prostate cancer compared to ADT+AAP. The short follow-up period limited the ability to explore differences in HRQoL after 25 weeks. Larger studies with longer follow-up are needed to further evaluate HRQoL with ADT-free strategies. Clinical trial information: NCT02867020. [Table: see text]

MicroRNA-based biomarkers of the radiation response in prostate cancer.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 163-163
Author(s):  
Joanne B. Weidhaas ◽  
Donatello Telesca ◽  
Amar Upadhyaya Kishan ◽  
Ingrid Jenny Guldvik ◽  
Melanie-Birte Schulz-Jaavall ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Locally Advanced ◽  
Predictive Biomarkers ◽  
Late Toxicity ◽  
Machine Learning Techniques ◽  
Genetic Associations ◽  
Ct Number ◽  
Prognostic Features ◽  
Gu Toxicity ◽  
Patient Reported

163 Background: Intermediate and high-risk prostate cancer can be cured with radiation (RT) to the prostate and pelvic lymph nodes with androgen deprivation therapy (ADT), but both acute and late toxicity of the GU and GI systems are common. There are no biomarkers predicting radiation outcomes, limiting the opportunity to best personalize prostate radiation therapy. Methods: A prospectively enrolled single arm trial for locally advanced prostate cancer patients (T1-T4N0-N1M0) treated with definitive RT (74Gy IMRT) plus ADT was studied. Biologic samples were available in 108 of 138 patients. Toxicity was recorded using the RTOG morbidity grading system. We applied a panel of microRNA-based germline mutations shown to predict cancer therapy endpoints. Machine learning techniques were used to simultaneously identify prognostic features and perform classification of the biomarkers. Upsampling nested LOO-CV was used to assess performance and generality. Independent Fisher’s exact tests were performed to identify statistically significant marginal associations. Three classifiers were studied: logistic regression with elastic net regularization (EN-LR), classification trees (CT), and random forests (RF), with corresponding hyper-parameters of regularization weights (EN-LR), minimum split and bucket level sample size (CT), number of trees and mtry (RF). Normalized on the simplex, feature importance was defined as absolute value of regression weights for EN-LR, and cumulative decrease in Gini impurity for primary and surrogate splits at each node/splits for CT and RF. Results: Grade 2 or higher toxicity included acute GI (11%), acute GU (34%), late GI (3%) and late GU (16%). GI and GU toxicity and acute and late toxicity had unique predictive biomarkers. The top three marginal genetic associations for late GU toxicity were microRNA site variants in CD6 and CD274 (PDL1)(p.val < 0.01) and BRCA2 (p.val = 0.014). Using RF, CT and EN_LR we could predict late GU toxicity with up to 70% sensitivity, 96% specificity, and 90% accuracy. Conclusions: We have identified microRNA-based biomarkers that can predict late GU toxicity. Work incorporating patient reported outcomes and to identify biomarkers for additional endpoints is ongoing.

scholarly journals Anorectal function and quality of life after chemoradiotherapy in patients with anal canal carcinoma

2017 ◽  
Vol 5 (2) ◽  
pp. 33-38
Author(s):  
Francesca De Felice ◽  
Daniela Musio ◽  
Gloria Bernardi ◽  
Lavinia Grapulin ◽  
Alessio Impagnatiello ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Fecal Incontinence ◽  
Anal Canal ◽  
Anorectal Manometry ◽  
Anorectal Function ◽  
Anal Canal Cancer ◽  
European Organization ◽  
Patient Reported ◽  
Sphincter Complex

Background: A retrospective study was conducted to evaluate sphincter function and quality of life (QoL) in patients treated with radiotherapy and concurrent chemotherapy (CRT) for anal canal cancer. Materials and Methods: From 1998 to 2010, patients with anal canal cancer treated with CRT were eligible. Radiation dose was 59.4 Gy (1.8 Gy/ fraction) and the chemotherapy regimen was 5-fluorouracil and mitomycin C. Anorectal function was investigated by anorectal manometry and transrectal ultrasound. QoL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C29 questionnaire. Correlations between diagnostic parameters and patient-reported outcomes were evaluated. Results: Eighteen patients were enrolled. Overall, 4 patients had stage I disease, 8 stage II and 6 stage III. Anorectal manometry parameters were significantly lower compared to healthy scores. Patients-reported continence was significantly higher than fecal incontinence manometry scores. Ultrasound sphincter complex defects were recorded in 17 patients. Globally, a positive correlation was described between resting pressure of manometric exam and sexual functioning items and sphincter complex and patient-reported flatulence, respectively. Conclusions: Definitive CRT represents the standard of care for anal canal cancer. Patients experienced low rates of fecal incontinence compared with results of diagnostic exams. Further studies are needed to better define toxicity and QoL after definitive CRT in anal canal cancer.

Locally advanced anal canal carcinoma: is the addition of cetuximab the answer?

2015 ◽  
Vol 31 (3) ◽  
pp. 751-752
Author(s):  
Francesca De Felice ◽  
Daniela Musio ◽  
Vincenzo Tombolini
Keyword(s):  
Anal Canal ◽  
Locally Advanced ◽  
Anal Canal Carcinoma

scholarly journals Phase 1 study of cetuximab in combination with 5-fluorouracil, cisplatin, and radiotherapy in patients with locally advanced anal canal carcinoma

Cancer ◽  
2013 ◽  
Vol 119 (16) ◽  
pp. 2973-2980 ◽  
Author(s):  
Luis O. Olivatto ◽  
Fernando M. Vieira ◽  
Bruno V. Pereira ◽  
Ana P. Victorino ◽  
Marcos Bezerra ◽  
...  
Keyword(s):  
Anal Canal ◽  
Phase 1 ◽  
Locally Advanced ◽  
Phase 1 Study ◽  
Anal Canal Carcinoma
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