Treatment of squamous cell anal canal carcinoma (SCACC) with pulsed dose rate brachytherapy:: A retrospective study

Background and purpose: To evaluate the results of pulsed dose rate brachytherapy (PDR) in SCACC. Material and methods: From 1996 to 2002, 71 patients (pts) with SCACC were treated with PDR brachytherapy. The median age was 61.2 years (35-88), with a sex ratio of 1 M/6.5 F. The TNM classification was: 14 T1, 41 T2, 15 T3 and 1 T4, 52 NO, 13 N1, 3 N2 and 3 N3. All the pts were MO. Treatment started with external beam irradiation to the posterior pelvis (mean dose: 45.5 Gy). Forty-seven patients received chemotherapy (neoadjuvant/concomitant or both). After an interval of 2-6 weeks, PDR interstitial brachytherapy was performed. The mean dose was 17.8 Gy to the 85% reference isodose of the Paris system. Results: Treatment was interrupted in only one pt. With a median follow-up of 28.5 months, 2-year actuarial overall survival was 90%. Fourteen relapses occurred (four distant, three regional, and seven local). Ten patients developed a grade III complication (Lent Soma scale) and two a grade IV complication (colostomy or abdominal perineal resection for necrosis). Conclusion: PDR appears to be an effective treatment for SCACC. It is capable of reproducing the results usually observed with continuous LDR. (c) 2006 Elsevier Ireland Ltd. All rights reserved.