Temporal improvements in loco-regional failure and survival in patients with anal cancer treated with chemo-radiotherapy: treatment cohort study (1990-2014).,British Journal of Cancer

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Temporal improvements in loco-regional failure and survival in patients with anal cancer treated with chemo-radiotherapy: treatment cohort study (1990-2014).
British Journal of Cancer ( IF 6.4 ) Pub Date : 2020-01-14 , DOI: 10.1038/s41416-019-0689-x
Hema Sekhar ₁ , Lee Malcomson ₁ , Rohit Kochhar ₂ , Matthew Sperrin ₃ , Nooreen Alam ₄ , Bipasha Chakrbarty ₅ , Paul E Fulford ₆ , Malcolm S Wilson ₆ , Sarah T O'Dwyer ₆ , Mark P Saunders ₄ , Andrew G Renehan _{1,

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Affiliation

BACKGROUND We evaluated oncological changes in patients with squamous cell carcinoma of the anus (SCCA) treated by chemoradiotherapy (CRT) from a large UK institute, to derive estimates of contemporary outcomes. METHODS We performed a treatment-cohort analysis in 560 patients with non-metastatic SCCA treated with CRT over 25 years. The primary outcomes were 3-year loco-regional failure (LRF), 5-year overall survival (OS), and 5-year cancer-specific survival (CSS). We developed prediction models; and overlaid estimates on published results from historic trials. RESULTS Age distributions, proportions by gender and cT stage remained stable over time. The median follow-up was 61 (IQR: 36-79) months. Comparing the first period (1990-1994) with the last period (2010-2014), 3-year LRF declined from 33 to 16% (Ptrends < 0.001); 5-year OS increased from 60% to 76% (Ptrends = 0.001); and 5-year CCS increased from 62% in to 80% (Ptrends = 0.001). For 2020, the models predicted a 3-year LRF of 14.7% (95% CIs: 0-31.3); 5-year OS of 74.7% (95% CIs: 54.6-94.9); and 5-year CSS of 85.7% (95% CIs: 75.3-96.0). Reported oncological outcomes from historic trials generally underestimated contemporary outcomes. CONCLUSIONS Current and predicted rates for 3-year LRF and 5-year survivals are considerably improved compared with those in historic trials.

中文翻译：

经化学放疗治疗的肛门癌患者局部区域衰竭和生存的暂时改善：治疗队列研究（1990-2014年）。

背景我们评估了英国一家大型机构通过化学放疗（CRT）治疗的肛门鳞状细胞癌（SCCA）患者的肿瘤学变化，以得出当代疗效的估计值。方法我们对560例25年来接受CRT治疗的非转移性SCCA患者进行了治疗队列分析。主要结局为3年局部区域衰竭（LRF），5年总生存期（OS）和5年癌症特异性生存期（CSS）。我们开发了预测模型；并根据历史试验对已发表的结果进行估算。结果年龄分布，按性别和cT阶段划分的比例随时间保持稳定。中位随访时间为61（IQR：36-79）个月。将第一个时期（1990-1994年）和最后一个时期（2010-2014年）进行比较，三年期LRF从33％下降到16％（趋势<0.001）；5年OS从60％增加到76％（趋势= 0.001）；5年CCS从62％提高到80％（趋势= 0.001）。模型预测2020年的3年LRF为14.7％（95％CI：0-31.3）; 5年OS为74.7％（95％CI：54.6-94.9）; 和5年CSS占85.7％（95％CI：75.3-96.0）。历史性试验报告的肿瘤学结果通常低估了当代结果。结论与历史性试验相比，当前和预期的3年LRF和5年生存率有了很大提高。历史性试验报告的肿瘤学结果通常低估了当代结果。结论与历史性试验相比，当前和预期的3年LRF和5年生存率有了显着提高。历史性试验报告的肿瘤学结果通常低估了当代结果。结论与历史性试验相比，当前和预期的3年LRF和5年生存率有了显着提高。

更新日期：2020-01-14

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