The standard of care for locally advanced anal cancer is definitive pelvic chemoradiotherapy (CRT).1–5 In the metastatic setting, chemotherapy (cisplatin/5-FU, carboplatin/paclitaxel, or FOLFOX) is considered the standard of care, and the role of definitive pelvic radiotherapy (RT) has not been established.6,7 However, chemotherapy with or without pelvic RT has been recommended in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for metastatic anal cancer (MAC), despite limited clinical evidence for RT in this setting.8 Yet, there is increasing evidence showing that local therapies may increase survival for some types of metastatic cancers.9–19
Because the literature on the potential benefit of definitive RT to the primary tumor in MAC is unclear, we analyzed the National Cancer Database (NCDB) to assess patterns of care and survival outcomes of chemotherapy with or without RT in patients with MAC. We hypothesized that patients who received definitive doses of pelvic RT for MAC would have improved survival compared with those who did not.
Disclosures: Dr. Ballo has disclosed that he is a member of the speakers bureau and serves as a consultant for Novocure. The remaining authors have disclosed that they have not received any financial considerations from any person or organization to support the preparation, analysis, results, or discussion of this article.
See JNCCN.org for supplemental online content.
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. James RD Glynne-Jones R Meadows HM Mitomycin or cisplatin chemoradiation with or without maintenance chemotherapy for treatment of squamous-cell carcinoma of the anus (ACT II): a randomised, phase 3, open-label, 2 x 2 factorial trial. Lancet Oncol 2013; 14: 516– 524.
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. Kachnic LA Winter K Myerson RJ RTOG 0529: a phase 2 evaluation of dose-painted intensity modulated radiation therapy in combination with 5-fluorouracil and mitomycin-C for the reduction of acute morbidity in carcinoma of the anal canal. Int J Radiat Oncol Biol Phys 2013; 86: 27– 33.
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