Image-guided Interstitial Brachytherapy in the Management of Metastasized Anal Squamous Cell Carcinoma

Anticancer Res. 2018 Sep;38(9):5401-5407. doi: 10.21873/anticanres.12870.

Abstract

Background/aim: Interstitial brachytherapy (IBT) has been shown to provide high tumor control rates in metastatic colorectal carcinoma. Our aim was to evaluate efficacy and safety of IBT in patients with metastatic anal squamous cell carcinoma (mASCC).

Patients and methods: Seven patients with a total of 38 unresectable ASCC metastases (28 liver, nine lung, one nodal metastases) were treated with computed tomographic or open magnetic resonance imaging-guided IBT using an iridium-192 source. Clinical and image-based follow-up were performed every 3 months after treatment.

Results: Local tumor control rate was 97.4% during a median follow-up of 15.2 months. Median progression-free survival was 3.3 months (range=2.5-32.6 months). Median overall survival after IBT was 25.2 months (range=6.5-51.0 months). No severe adverse events (grade 3 or more) were recorded.

Conclusion: Image-guided IBT is a safe and particularly effective treatment in patients with mASCC and might provide a well-tolerated therapeutic option in a multidisciplinary setting.

Keywords: Anal cancer; image-guided intervention; interstitial brachytherapy; interventional oncology; metastases.

MeSH terms

  • Aged
  • Anus Neoplasms / mortality
  • Anus Neoplasms / pathology
  • Anus Neoplasms / radiotherapy*
  • Brachytherapy / adverse effects
  • Brachytherapy / methods*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / radiotherapy*
  • Carcinoma, Squamous Cell / secondary
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms / mortality
  • Liver Neoplasms / radiotherapy*
  • Liver Neoplasms / secondary
  • Lung Neoplasms / mortality
  • Lung Neoplasms / radiotherapy*
  • Lung Neoplasms / secondary
  • Lymphatic Metastasis
  • Magnetic Resonance Imaging, Interventional* / adverse effects
  • Male
  • Middle Aged
  • Radiography, Interventional / adverse effects
  • Radiography, Interventional / methods*
  • Radiotherapy, Image-Guided / adverse effects
  • Radiotherapy, Image-Guided / methods*
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Tomography, X-Ray Computed* / adverse effects
  • Treatment Outcome