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http://dx.doi.org/10.3857/roj.2015.33.2.83

Can we omit prophylactic inguinal nodal irradiation in anal cancer patients?  

Kim, Hakyoung (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Park, Hee Chul (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Yu, Jeong Il (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Choi, Doo Ho (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Ahn, Yong Chan (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Kim, Seung Tae (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Park, Joon Oh (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Park, Young Suk (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Kim, Hee Cheol (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Publication Information
Radiation Oncology Journal / v.33, no.2, 2015 , pp. 83-88 More about this Journal
Abstract
Purpose: To evaluate the appropriateness of prophylactic inguinal nodal irradiation (PINI), we analyzed patterns of failure in anal cancer patients who were inguinal node-negative at presentation and did not receive PINI. Materials and Methods: We retrospectively reviewed the records of 33 anal cancer patients treated by definitive concurrent chemoradiation therapy (CCRT) between 1994 and 2013. Radiotherapy consisted of a total dose of 44-45 Gy (22-25 fractions in 5 weeks) on the whole pelvis, anus, and perineum. Except inguinal lymphadenopathy was present at initial diagnosis, the entire inguinal chain was not included in the radiation field. In other words, there was no PINI. Results: The median follow-up duration was 50 months (range, 4 to 218 months). Median survival and progression-free survival (PFS) were 57 months (range, 10 to 218 months) and 50 months (range, 4 to 218 months), respectively. Among the survival, the median follow-up duration was 51 months (range, 12 to 218 months). The 5-year overall survival and PFS rates were 93.4% and 88.8%, respectively. Although none of the patients received inguinal node irradiation for prophylactic purposes, there was no inguinal recurrence. Conclusion: Treatment of anal cancer by omitting PINI might be considered in selected patients with clinically uninvolved inguinal nodes.
Keywords
Anus neoplasms; Prophylactic; Radiotherapy; Inguinal; Lymph nodes;
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