Title Chemoradiation in anal carcinoma: results and prognostic factors Title (croatian) Kemoterapija u karcinomu anusa: rezultati i prognostički faktori Author Nils Krüger Mentor Georg Gerhard Grabenbauer (mentor) Committee member Johannes Brachmann (predsjednik povjerenstva) Committee member Georg Heinrich Breuer (član povjerenstva) Committee member Josipa Bukić (član povjerenstva)Granter University of Split Defense date and country 2024-07-18, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Objectives: This study aimed to evaluate survival data in anal cancer patients following treatment in the Coburg cancer center. The objective was to identify prognostic factors that modify the outcome for these patients.
Material and methods: Patients treated between 2011 and 2022 for anal cancer were selected from the Coburg Cancer center. For this retrospective study 60 patients were used after excluding 3 patients due to various reasons (change of citizenship und inclomplete treatment) Analysis of the data was focused age at initial diagnosis, gender, duration of radiotherapy, single and total dosages of radiation, TMN classification, overall survival, NED survival, reoccurrences and treatment differences like the concurrent usage of chemotherapy. For the analysis of statistical data IMB SPSS Statistic version 19 was used. To determine the distribution of data the Shapiro-Wilk Test was employed. Survival rated were calculated by Kaplan Meier method. The log rank and Wilcoxon Rank test were used to calculate differences in survival rated between groups of patients. Qualitative data were expressed as whole numbers and percentages, while quantitative data were expressed as mean ± standard deviation or median and iqr.
Results: In this study the gender distribution was 15 male and 45 female patients. From these 60 people 36 were in the T1-2 stadium at initial diagnose and 24 were in T3-4. 73% (44 patients) had no lymph node involvement. The median radiation dose received was 50.4 Gy with a range from 45 to 59.4 Gy. During the treatment 14 people received a combination of chemotherapy and radiotherapy, while the other 46 received only radiotherapy. The five-year overall survival, 5-year-NED survival, 5- locoregional failure-free survival rates were 68%, 82%, 87%, respectively. Correlations between OS and NED free time, locoregional failure free time and colostomy free time have been established. No significant impact on the five year survival was found for TMN classification or differences in treatment with or without chemotherapy in this study. Slight differences were seen using the Kaplan Meier curves but not to a great extent.
Conclusion: No significant prognostic factor for the outcomes for anal cancer patients has been found in this study. Relationships between OS and NED survival time, locoregional failure-free time, and colostomy-free time have been established. Interpreting these findings should be done with caution due to the consideration of confounding factors. More research is required to comprehend the factors that influence outcomes in patients with anal cancer.
Abstract (english) Ciljevi: Ova studija imala je za cilj procijeniti podatke o preživljavanju pacijenata s karcinomom anusa nakon liječenja u Coburg centru za rak. Cilj je bio identificirati prognostičke faktore koji utječu na ishode kod ovih pacijenata.
Materijali i metode: Pacijenti liječeni između 2011. i 2022. godine zbog karcinoma anusa odabrani su iz Coburg centra za rak. U ovoj retrospektivnoj studiji uključeno je 60 pacijenata, nakon isključenja 3 pacijenta zbog različitih razloga (promjena državljanstva i nepotpuno liječenje). Analiza podataka fokusirala se na dob pri početnoj dijagnozi, spol, trajanje radioterapije, pojedinačne i ukupne doze zračenja, TMN klasifikaciju, ukupno preživljavanje, NED preživljavanje, recidive i razlike u liječenju poput istovremene primjene kemoterapije. Za analizu statističkih podataka korišten je IMB SPSS Statistic verzija 19. Za određivanje distribucije podataka korišten je Shapiro-Wilk test. Stope preživljavanja izračunate su KaplanMeier metodom. Log-rank i Wilcoxon Rank test korišteni su za izračun razlika u stopama preživljavanja među skupinama pacijenata. Kvalitativni podaci izraženi su u cijelim brojevima i postocima, dok su kvantitativni podaci izraženi kao srednja vrijednost ± standardna devijacija ili srednja medijani interkvartilni raspon.
Rezultati: U ovoj studiji raspodjela po spolu bila je 15 muškaraca i 45 žena. Od tih 60 osoba, 36 je bilo u stadiju T1-2 pri početnoj dijagnozi, a 24 u stadiju T3-4. 73% (44 pacijenta) nije imalo zahvaćenost limfnih čvorova. Medijan primljene doze zračenja bio je 50,4 Gy s rasponom od 45 do 59,4 Gy. Tijekom liječenja 14 osoba je primilo kombinaciju kemoterapije i radioterapije, dok su ostalih 46 primili samo radioterapiju. Petogodišnje ukupno preživljavanje, petogodišnje NED preživljavanje i petogodišnje preživljavanje bez lokoregionalnog recidiva iznosili su 68%, 82% i 87%, redom. Utvrđene su korelacije između OS i NED preživljenja, vremena bez lokoregionalnog recidiva i vremena bez kolostomije. Nije utvrđen značajan utjecaj na petogodišnje preživljavanje za TMN klasifikaciju ili razlike u liječenju s ili bez kemoterapije u ovoj studiji. Blage razlike su zabilježene koristeći Kaplan-Meier krivulje, ali ne u velikoj mjeri.
Zaključak: U ovoj studiji nije pronađen značajan prognostički faktor za ishode pacijenata s karcinomom anusa. Utvrđene su veze između OS i NED preživljenja, vremena bez lokoregionalnog recidiva i vremena bez kolostomije. Tumačenje ovih nalaza treba se provesti s oprezom zbog razmatranja zbunjujućih faktora. Potrebno je više istraživanja kako bi se razumjeli faktori koji utječu na ishode kod pacijenata s karcinomom anusa.
Keywords
Anal carcinoma
prognostic factors
radiation therapy
chemotherapy
squamous cell cancer of the anal canal
Keywords (english)
karcinom anusa
prognostički čimbenici
terapija zračenjem
kemoterapija
planocelularni karcinom analnog kanala
Language english URN:NBN urn:nbn:hr:171:890581 Study programme Title: Medical Studies in English Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2024-07-30 09:48:53
