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[Brachytherapy for anal cancers].

P Pommier1, X Mirabel, J-M Hannoun-Lévi

  • 1Département de radiothérapie, centre Léon-Bérard, 28, rue Laënnec, 69373 Lyon cedex 08, France. pascal.pommier@lyon.unicancer.fr

Cancer Radiotherapie : Journal De La Societe Francaise De Radiotherapie Oncologique
|April 16, 2013
PubMed
Summary
This summary is machine-generated.

Low dose-rate brachytherapy boosts chemoradiation for anal cancer, improving local control. This standard treatment involves external beam radiotherapy followed by brachytherapy, with pulsed dose rate brachytherapy as a viable alternative.

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Medical Physics

Background:

  • Low dose-rate brachytherapy is a standard boost after chemoradiation for locally advanced anal carcinoma.
  • Selection for brachytherapy boost depends on initial staging and tumor response to external beam radiotherapy.
  • Brachytherapy boost offers superior local control compared to external beam radiotherapy boost.

Purpose of the Study:

  • To describe the brachytherapy procedure for anal carcinoma.
  • To outline the standard treatment protocol.
  • To discuss alternative brachytherapy techniques and their current evaluation.

Main Methods:

  • Standard protocol: 45 Gy pelvic external beam radiotherapy with 5-fluorouracil and mitomycin-C, followed by a 15 Gy brachytherapy boost.
  • Brachytherapy boost gap limited to 2-3 weeks.
  • Evaluation of pulsed dose rate brachytherapy as an alternative to low dose rate brachytherapy.

Main Results:

  • Local control is superior with brachytherapy boost compared to external beam radiotherapy.
  • Higher irradiation doses have not shown improved colostomy-free survival.
  • Exclusive brachytherapy is not recommended for early-stage anal carcinoma due to high recurrence risk.

Conclusions:

  • Low dose-rate brachytherapy boost is effective for locally advanced anal carcinoma.
  • Pulsed dose rate brachytherapy is a suitable alternative, maintaining recommended dose rates.
  • High dose rate brachytherapy requires further evaluation.