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Background <p>Intensity-modulated radiation therapy (IMRT) may reduce mortality in patients with squamous cell carcinoma of the anus (SCCA), but there are limited data in long-term outcomes. This study reported 5-year outcomes in SCCA patients treated with IMRT-based definitive chemoradiation.</p> Methods <p>Sixty-five consecutive patients with T1-4N0-3M0 SCCA treated with IMRT-based concurrent chemoradiation (CCRT) from Jan 1, 2010, were retrospectively reviewed. Treatment outcomes included overall survival (OS), disease-free survival (DFS), anal cancer-specific mortality (ACSM), local-regional failure (LRF), distant metastasis (DM) and colostomy failure (CF), late toxicity and anorectal function.</p> Results <p>The patients had a median age of 52 years; 70.8% were female, 30.8% had T3-4 lesions, and 46.2% were clinically node positive. The median radiation doses to the gross tumor volume of the anus (GTV<sub>A</sub>) was 54&#xa0;Gy (with a median BED<sub>10</sub> of 65.7&#xa0;Gy). The 5-year OS and DFS rates were 82.4% and 74.6%, respectively. The 5-year rates of ACSM, LRF, DM and CF were 13.9%, 18.0%, 6.5% and 19.0%, respectively. Patients treated with BED<sub>10</sub> &gt; 66&#xa0;Gy exhibited inferior DFS and OS. The most common grade 3 late AEs were gastrointestinal (6.2%). The median Wexner score and Vaizey score were 0 and 2, respectively. The median LARS score was 0, with 3 patients reporting minor LARS.</p> Conclusion <p>IMRT-based CCRT can achieve excellent long-term local control with manageable late toxicity in patients with locoregional SCCA. Anorectal function in long-term survivors was acceptable. Given different tumor burden, findings regarding radiation dose escalation beyond a BED<sub>10</sub> of 66&#xa0;Gy should be interpreted with caution.</p>

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Long-term outcomes and anorectal functional status of patients with anal squamous cell carcinoma treated with the modern technique of intensity-modulated radiotherapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月27日

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  • Tongzhen Xu,
  • Jinming Shi,
  • Huiying Ma,
  • Jiacheng Shuai,
  • Shulian Wang,
  • Yongwen Song,
  • Yueping Liu,
  • Hui Fang,
  • Ningning Lu,
  • Shunan Qi,
  • Bo Chen,
  • Yirui Zhai,
  • Wenwen Zhang,
  • Hao Jing,
  • Yexiong Li,
  • Ning Li,
  • Yuan Tang,
  • Jing Jin

摘要

Background

Intensity-modulated radiation therapy (IMRT) may reduce mortality in patients with squamous cell carcinoma of the anus (SCCA), but there are limited data in long-term outcomes. This study reported 5-year outcomes in SCCA patients treated with IMRT-based definitive chemoradiation.

Methods

Sixty-five consecutive patients with T1-4N0-3M0 SCCA treated with IMRT-based concurrent chemoradiation (CCRT) from Jan 1, 2010, were retrospectively reviewed. Treatment outcomes included overall survival (OS), disease-free survival (DFS), anal cancer-specific mortality (ACSM), local-regional failure (LRF), distant metastasis (DM) and colostomy failure (CF), late toxicity and anorectal function.

Results

The patients had a median age of 52 years; 70.8% were female, 30.8% had T3-4 lesions, and 46.2% were clinically node positive. The median radiation doses to the gross tumor volume of the anus (GTVA) was 54 Gy (with a median BED10 of 65.7 Gy). The 5-year OS and DFS rates were 82.4% and 74.6%, respectively. The 5-year rates of ACSM, LRF, DM and CF were 13.9%, 18.0%, 6.5% and 19.0%, respectively. Patients treated with BED10 > 66 Gy exhibited inferior DFS and OS. The most common grade 3 late AEs were gastrointestinal (6.2%). The median Wexner score and Vaizey score were 0 and 2, respectively. The median LARS score was 0, with 3 patients reporting minor LARS.

Conclusion

IMRT-based CCRT can achieve excellent long-term local control with manageable late toxicity in patients with locoregional SCCA. Anorectal function in long-term survivors was acceptable. Given different tumor burden, findings regarding radiation dose escalation beyond a BED10 of 66 Gy should be interpreted with caution.