The Swedish National Care Programme for Anal Carcinoma -: Implementation and overall results

被引:17
作者
Friberg, B [1 ]
Svensson, C
Goldman, S
Glimelius, B
机构
[1] Sodersjukhuset Hosp, Karolinska Inst, Dept Surg, Akad Sjukhuset, S-11883 Stockholm, Sweden
[2] Huddinge Univ Hosp, So Stockholms Dept Oncol, Stockholm, Sweden
[3] Ersta Hosp, Dept Surg, Stockholm, Sweden
[4] Uppsala Univ, Akad Sjukhuset, Dept Oncol, Uppsala, Sweden
关键词
D O I
10.1080/028418698423140
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The Swedish National Care Programme for Anal Carcinoma (SNCPAC) was instituted in order to create a uniform handling policy for anal cancer and thus to accrue a population-based material allowing unbiased analyses. This study evaluates the degree of implementation of the SNCPAC guidelines, and presents overall treatment results in a total of 356 patients with epidermoid cancer of the anus and the perianal region diagnosed in Sweden between 1985 and 1989. Primary treatment according to the guidelines was irradiation up to 40 Gy. Bleomycin was administered intramuscularly before the first 18 fractions. After a 3-week pause, radiotherapy was to be continued up to a dose of 60-64 Gy, if at least an almost complete response was achieved. Otherwise, the patient was recommended surgery within a week. The guidelines were applied in 90% of cases where such treatment was possible. The 5-year tumour-specific survival rate was 72%. The survival rate was more favourable in perianal rumours (90%) than in anal canal tumours (68%, p < 0.01). The 5-year probability of having a preserved anus was 64% (anal canal/perianal 58%/91%, p < 0.001). Bleomycin did not appear to have any effect on treatment results. The care programme has had a rapid and almost complete nation-wide penetration, and h as created the desired uniformity allowing proper analyses. The treatment results also appear comparable with specialised referral centres.
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页码:25 / 32
页数:8
相关论文
共 45 条
[1]  
Arnott SJ, 1996, LANCET, V348, P1049
[2]   Concomitant radiotherapy and chemotherapy is superior to radiotherapy alone in the treatment of locally advanced anal cancer: Results of a phase III randomized trial of the European organization for research and treatment of cancer radiotherapy and gastrointestinal cooperative groups [J].
Bartelink, H ;
Roelofsen, F ;
Eschwege, F ;
Rougier, P ;
Bosset, JF ;
Gonzalez, DG ;
Peiffert, D ;
vanGlabbeke, M ;
Pierart, M .
JOURNAL OF CLINICAL ONCOLOGY, 1997, 15 (05) :2040-2049
[3]  
BRESLOW NE, 1980, LION IARC, V21, P1115
[4]  
BRUNET R, 1990, P ASCO, V9, P402
[5]  
CHAN PYM, 1976, CANCER, V37, P2671, DOI 10.1002/1097-0142(197606)37:6<2671::AID-CNCR2820370615>3.0.CO
[6]  
2-5
[7]  
CUMMINGS BJ, 1987, GASTROENTEROL CLIN N, V16, P125
[8]   EPIDERMOID ANAL CANCER - TREATMENT BY RADIATION ALONE OR BY RADIATION AND 5-FLUOROURACIL WITH AND WITHOUT MITOMYCIN-C [J].
CUMMINGS, BJ ;
KEANE, TJ ;
OSULLIVAN, B ;
WONG, CS ;
CATTON, CN .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1991, 21 (05) :1115-1125
[9]   THE PLACE OF RADIATION-THERAPY IN THE TREATMENT OF CARCINOMA OF THE ANAL-CANAL [J].
CUMMINGS, BJ .
CANCER TREATMENT REVIEWS, 1982, 9 (02) :125-147
[10]  
CUMMINGS BJ, 1993, ONCOLOGY-BASEL, V50, P63