Combination of Radiation, Chemotherapy Successfully Treats Anal Cancer, UPCI Study Finds

PET/CT-based Intensity Modulated Radiation Therapy (IMRT), a radiation therapy technique that delivers precise radiation to tumors while sparing the surrounding normal tissue, may effectively control and treat cancers of the anus when combined with chemotherapy, according to researchers from the University of Pittsburgh Cancer Institute (UPCI).

The study was led by Regiane de Andrade, a resident of radiation oncology with UPMC Cancer Centers who is overseen by Dwight E. Heron, a professor and vice chair of the Department of Radiation Oncology in the University of Pittsburgh School of Medicine. The research revealed that patients with anal carcinoma who had a diagnostic PET/CT as part of their radiation treatment planning had excellent response rates to treatment and experienced fewer overall toxicities.

“While treatment options for patients with anal cancers have come a long way, they can still be physically debilitating,” said de Andrade. “With IMRT, we can decrease toxicities and improve patients’ compliance with treatment.”

The study reviewed the experiences of 31 patients treated for cancers of the anus at UPMC Cancer Centers between March 2003 and March 2009. All patients underwent PET/CT imaging before treatment to better assess the extent of their disease and to accurately identify the tumors to be targeted. All patients received chemotherapy concurrent with radiation, and all patients completed the planned treatment with few toxic side effects and excellent control of the disease.

The combination of PET/CT and IMRT allows for more accurate tumor localization for radiation delivery while reducing toxicity to the rest of the body, de Andrade said.

While chemoradiation has become the standard of care for treating patients with anal carcinoma, typically resulting in good disease control and the ability to avoid a colostomy, treatment-related toxicities can be significant and can cause patients to delay or even cease treatment.

The research results were presented in early November during the American Society for Radiation Oncology annual meeting in San Diego.

The study was funded by the Department of Radiation Oncology, University of Pittsburgh Cancer Institute.