A retrospective analysis of concurrent chemoradiation for squamous cell carcinoma of the anus in Johannesburg

SA Journal of Oncology

Field Value
Title A retrospective analysis of concurrent chemoradiation for squamous cell carcinoma of the anus in Johannesburg
Creator Tshoeu, Phemelo Sharma, Vinay Ruff, Paul
Subject Radiation Oncology anal cancer; squamous cell carcinoma; chemotherapy; chemoradiation; HIV; antiretroviral therapy; mitomycin; HPV
Description Background: Anal cancer is a major cause of mortality and morbidity in low- and middle-income countries (LMICs).Aim: A retrospective analysis to understand presentation and outcomes of patients with anal cancer, who were treated with a curative intent.Setting: A radiation oncology unit in quaternary level hospital in South Africa.Methods: Medical records of patients with invasive squamous cell carcinoma (SCC) of the anal canal who were treated between 2014 and 2019 were reviewed with follow-up until June 2021. The 2D-radiotherapy planning and delivery techniques were used to a dose of 50 Gy, with a boost dose of 6 Gy – 10 Gy for patients with residual disease and concurrent chemotherapy.Results: Eighty-four patients were included in the analysis. Median age was 45 years (range: 25–73 years), 75% were female patients, 80% of the cohort was human immunodeficiency virus (HIV)-positive, and 17% with a CD4 count below 200 cells/mm3. Eighty-seven percent had locally advanced stage three disease. Concurrent 5-fluorouracil (5-FU) and mitomycin C-based chemotherapy was given in four patients, while 50% had 5-FU plus cisplatin and 16% had radiotherapy alone. Complete clinical response was observed in 54 out of 66 evaluable patients (81.8%) at 6 months post-chemoradiation. Overall survival at 2 years could not be determined because of a significant loss to follow-up rate.Conclusion: A high HIV-postive rate and an advanced disease stage were observed among cohorts with anal canal SCC treated with a definitive curative intent. Tumour response rates at 6 months were favourable although the 2-year overall survival could not be established.Contribution: This study contributes to the growing body of research on anal cancer outcomes in LMICs.
Publisher AOSIS
Contributor No supporting agencies
Date 2023-09-19
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Retrospective review
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajo.v7i0.270
Source South African Journal of Oncology; Vol 7 (2023); 7 pages 2523-0646 2518-8704
Language eng
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://sajo.org.za/index.php/sajo/article/view/270/778 https://sajo.org.za/index.php/sajo/article/view/270/779 https://sajo.org.za/index.php/sajo/article/view/270/780 https://sajo.org.za/index.php/sajo/article/view/270/781
Coverage Africa; South Africa; Gauteng; Johannesburg January 2014 - December 2019 Patients with histologically proven squamous cell carcinoma of the anus. Median age 45 years (range 25 – 73), 75% were female patients, 80% of the cohort was HIV infected.
Rights Copyright (c) 2023 Phemelo Tshoeu, Vinay Sharma, Paul Ruff https://creativecommons.org/licenses/by/4.0