ABSTRACT
BACKGROUND: Chemoradiotherapy (CRT) with flourouracil and mitomycin is the standard treatment for squamous cell carcinoma of the anus (SCCA), however the associated acute toxicity often hinders compliance. Although weekly cisplatin is a well-established treatment for other squamous cell carcinomas, it has not been explored in SCCA. PURPOSE: To investigate if radiotherapy (RT) with weekly cisplatin is a feasible option for SCCA and to report the acute toxicity. MATERIAL/METHODS: Patients were treated with RT and weekly cisplatin 40â¯mg/m2 between 1998-2020. Retrospective data from medical records (nâ¯=â¯65) and prospectively collected data from an observational study (nâ¯=â¯51) comprising physicianassessed toxicity (NCI-CTCAE 4.0), patient-reported outcomes (EORTC-QlQC30â¯+â¯CR29) baseline, mid-therapy, end of treatment and 2-4â¯weeks post-treatment were included. Disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan-Meier method. RESULTS: We included 116 patients. T-stages were T1:4â¯%, T2: 71â¯%, T3: 17â¯%, T4: 8â¯% and 47â¯% has Nâ¯+â¯disease. RT doses were 53.75-64â¯Gy/45-51.2â¯Gy and the mean cumulative dose of cisplatin was 307.5â¯mg. The median overall treatment time was 43â¯days. Within 6â¯months after CRT 88.9â¯% had complete response. The median follow-up time was 4.5â¯years and 5-year DFS and OS were 77â¯% (95â¯%CI 68.7-84.5â¯%) and 86.4â¯% (95â¯%CI 78.3-91.7â¯%), respectively. Hospitalization occured in 20â¯% with 2.6â¯% being admitted due to febrile neutropenia. Hematological toxicty was low with 13.7â¯% grade 3 and 3.9â¯% grade 4. Anal pain, skin, gastrointestinal and urogenital toxicity were mild. CONCLUSION: RT and weekly cisplatin for SCCA showed good outcome results and an acceptable acute toxicity profile.