De-Escalation of Therapy for Patients with Early-Stage Squamous Cell Carcinoma of the Anus

被引:6
|
作者
Miller, Eric [1 ,2 ]
Bazan, Jose [1 ,2 ]
机构
[1] Ohio State Univ, Comprehens Canc Ctr, Arthur G James Canc Hosp, Dept Radiat Oncol, Columbus, OH 43210 USA
[2] Ohio State Univ, Comprehens Canc Ctr, Richard J Solove Res Inst, Columbus, OH 43210 USA
基金
美国国家卫生研究院;
关键词
anal cancer; radiation therapy; chemoradiation; de-escalation of therapy; MODULATED RADIATION-THERAPY; ACUTE HEMATOLOGIC TOXICITY; CANAL CANCER-PATIENTS; ANAL CANCER; CONCURRENT CHEMOTHERAPY; COLOSTOMY FAILURE; MITOMYCIN-C; RADIOTHERAPY; CHEMORADIATION; MANAGEMENT;
D O I
10.3390/cancers13092099
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Simple Summary Management of early-stage squamous cell carcinoma of the anus (SCCA) remains controversial. The current standard of care treatment of chemotherapy combined with radiation therapy can result in both acute and late toxicity. Alternative therapies, including radiation therapy alone or local excision, may be less toxic, but the role of these therapies in early-stage SCCA remains unclear. Additional options for reducing the intensity of therapy for early-stage SCCA include reduction of radiation dose, altering treatment volumes, modifying chemotherapy type and dosage, and using intensity-modulated radiation therapy to reduce the radiation dose to adjacent normal tissues. Multiple prospective studies are actively investigating the role of de-escalation of therapy in patients with early-stage SCCA. The incidence of squamous cell carcinoma of the anus (SCCA) is increasing, particularly in the elderly, with increased mortality in this age group. While the current standard of care for localized SCCA remains chemoradiation (CRT), completion of this treatment can be challenging with risks for severe acute and late toxicity. It remains unclear if full course CRT is required for the management of early-stage SCCA or if de-escalation of treatment is possible without compromising patient outcomes. Alternative therapies include radiation therapy alone or local excision for appropriate patients. Modifying standard CRT may also reduce toxicity including the routine use of intensity-modulated radiation therapy for treatment delivery, modification of treatment volumes, and selection and dosing of concurrent systemic therapy agents. Finally, we provide an overview of currently accruing prospective trials focused on defining the role of de-escalation of therapy in patients with early-stage SCCA.
引用
收藏
页数:14
相关论文
共 50 条
  • [21] Bronchial sleeve resection for early-stage squamous cell carcinoma
    Goto, Taichiro
    Maeshima, Arafumi
    Akanabe, Kumi
    Kato, Ryoichi
    JOURNAL OF CARDIOTHORACIC SURGERY, 2012, 7
  • [22] Moderately Differentiated Early-Stage Buccal Squamous Cell Carcinoma
    lokhande, Shraddha U.
    Meshram, Priyanka S.
    Umate, Roshan
    Adhau, S. P.
    Gujar, Samruddhi
    INTERNATIONAL JOURNAL OF EARLY CHILDHOOD SPECIAL EDUCATION, 2022, 14 (04) : 2391 - 2394
  • [23] De-escalation treatment protocols for human papillomavirus-associated oropharyngeal squamous cell carcinoma
    Masterson, Liam
    Moualed, Daniel
    Masood, Ajmal
    Dwivedi, Raghav C.
    Benson, Richard
    Sterling, Jane C.
    Rhodes, Kirsty M.
    Sudhoff, Holger
    Jani, Piyush
    Goon, Peter
    COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2014, (02):
  • [24] De-escalation of Radiochemotherapy in prognostically favorable HPV- associated Squamous Cell Carcinoma of the Oropharynx
    Hermann, R. M.
    Christiansen, H.
    STRAHLENTHERAPIE UND ONKOLOGIE, 2016, 192 (04) : 273 - 275
  • [25] De-escalation Therapy and Remission
    Nuesslein, H. G.
    ZEITSCHRIFT FUR RHEUMATOLOGIE, 2014, 73 (09): : 782 - 782
  • [26] De-escalation of axillary staging in patients ≥70 with early-stage hormone positive and clinically node-negative breast cancer
    Daniele, Karla
    Thompson, Diane
    Anderson, Stewart
    Keleher, Angela
    Julian, Thomas
    ANNALS OF SURGICAL ONCOLOGY, 2022, 29 (SUPPL 1) : 80 - 81
  • [27] Radiotherapy for patients with early-stage glottic squamous cell carcinoma of the larynx: Interest of hypofractionation?
    Tonneau, M.
    Matta, R.
    Lals, S.
    Mirabel, X.
    Crop, F.
    Lacornerie, T.
    Pasquier, D.
    Escande, A.
    Liem, X.
    CANCER RADIOTHERAPIE, 2021, 25 (08): : 801 - 810
  • [28] Classification and survival prediction for early-stage lung adenocarcinoma and squamous cell carcinoma patients
    Tian, Suyan
    ONCOLOGY LETTERS, 2017, 14 (05) : 5464 - 5470
  • [29] Impact of Obesity on the Survival of Patients With Early-Stage Squamous Cell Carcinoma of the Oral Tongue
    Iyengar, Neil M.
    Kochhar, Amit
    Morris, Patrick G.
    Morris, Luc G.
    Zhou, Xi K.
    Ghossein, Ronald A.
    Pino, Alejandro
    Fury, Matthew G.
    Pfister, David G.
    Patel, Snehal G.
    Boyle, Jay O.
    Hudis, Clifford A.
    Dannenberg, Andrew J.
    CANCER, 2014, 120 (07) : 983 - 991
  • [30] Neck dissection improves the prognosis of patients with early-stage oral squamous cell carcinoma
    He, Yungang
    Shui, Haonan
    Liu, Jia
    He, Yuehang
    Wu, Jian
    Chen, Qiuzhi
    SCIENTIFIC REPORTS, 2025, 15 (01):