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Background <p>Anal high-grade squamous intraepithelial lesions (HSIL) represent precancerous alterations particularly affecting immunocompromised individuals. Current treatment options such as excision, ablative or topical treatment are frequently associated with recurrences. Repeated interventions can result in a&#xa0;considerable burden. Alternative treatments such as radiotherapy (RT) are rarely used and insufficiently studied. This study evaluates the acceptance and perception of RT as an alternative organ-preserving treatment option for recurrent HSIL from the perspectives of both coloproctologists and patients.</p> Methods <p>Exploratory anonymized cross-sectional survey including 13&#xa0;patients with recurrent HSIL and 40&#xa0;coloproctologists in Germany. Data collected included therapeutic experiences, perceived disease burden, treatment-related side effects and attitudes towards RT.</p> Results <p>Patients reported multiple prior surgical interventions and described the disease as highly burdensome, particularly due to pain, incontinence and repeated surgical procedures. Physicians reported clinically relevant recurrence rates following standard treatment. The use of RT was considered a&#xa0;potentially meaningful alternative treatment option, especially in recurrent HSIL. While only a&#xa0;minority of coloproctologists had practical experience with RT, many could conceive its use in selected cases. Patient awareness of RT as a&#xa0;treatment option was limited; however, a&#xa0;relevant proportion expressed openness toward this approach, particularly in the setting of recurrences.</p> Conclusion <p>Given the substantial disease burden and relevant recurrence rates in HSIL the current concepts require a&#xa0;thorough re-evaluation. Additionally, RT could represent a&#xa0;potential alternative treatment option from both patient and clinician perspectives, particularly after exhaustion of standard forms of treatment; however, retrospective analyses and further studies evaluating efficacy, safety and patient-reported outcomes are necessary.</p>

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Anale hochgradige squamöse intraepitheliale Läsionen und Strahlentherapie

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月26日

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  • Claudia Rudroff,
  • Richard Weiten,
  • Jordis Schaufenberg,
  • Emmanouil Fokas,
  • Hendrik Dapper

摘要

Background

Anal high-grade squamous intraepithelial lesions (HSIL) represent precancerous alterations particularly affecting immunocompromised individuals. Current treatment options such as excision, ablative or topical treatment are frequently associated with recurrences. Repeated interventions can result in a considerable burden. Alternative treatments such as radiotherapy (RT) are rarely used and insufficiently studied. This study evaluates the acceptance and perception of RT as an alternative organ-preserving treatment option for recurrent HSIL from the perspectives of both coloproctologists and patients.

Methods

Exploratory anonymized cross-sectional survey including 13 patients with recurrent HSIL and 40 coloproctologists in Germany. Data collected included therapeutic experiences, perceived disease burden, treatment-related side effects and attitudes towards RT.

Results

Patients reported multiple prior surgical interventions and described the disease as highly burdensome, particularly due to pain, incontinence and repeated surgical procedures. Physicians reported clinically relevant recurrence rates following standard treatment. The use of RT was considered a potentially meaningful alternative treatment option, especially in recurrent HSIL. While only a minority of coloproctologists had practical experience with RT, many could conceive its use in selected cases. Patient awareness of RT as a treatment option was limited; however, a relevant proportion expressed openness toward this approach, particularly in the setting of recurrences.

Conclusion

Given the substantial disease burden and relevant recurrence rates in HSIL the current concepts require a thorough re-evaluation. Additionally, RT could represent a potential alternative treatment option from both patient and clinician perspectives, particularly after exhaustion of standard forms of treatment; however, retrospective analyses and further studies evaluating efficacy, safety and patient-reported outcomes are necessary.