Radio-chemotherapy (RCT) is the primary treatment of anal cancer (AC). However, the role and the optimal total dose of a radiation boost is still unclear. No randomized controlled trials nor systematic reviews have been performed to analyze the efficacy of brachytherapy (BRT) as boost in AC. Therefore, we performed this systematic review based on PRISMA methodology to establish the role of BRT boost in AC. A systematic search of the bibliographic databases: PubMed, Scopus, and Cochrane library from the earliest possible date through January 31, 2018 was performed. At least one of the following outcomes: local control (LC), loco-regional control (LRC), overall survival (OS), disease-free survival (DFS), or colostomy-free survival (CFS) had to be present for inclusion in this systematic review in patients receiving a BRT boost. Data about toxicity and sphincter function were also included. Ten articles fulfilled the inclusion criteria. All the studies had retrospective study design. All studies were classified to provide a level of evidence graded as 3 according to SIGN classification. Median 5-year LC/LRC, CFS, DFS, and OS were: 78.6% (range, 70.7-92.0%), 76.1% (range, 61.4-86.4%), 75.8% (range, 65.9-85.7%), and 69.4% (63.4-82.0%), respectively. The reported toxicities were acceptable. RCT is the treatment cornerstone in AC. High-level evidences from studies on BRT boost in AC are lacking. Further studies should investigate: efficacy of BRT boost in comparison to no boost and to external beam boost, patients who can benefit from this treatment intensification, and optimal radiation dose.

Brachytherapy boost after chemoradiation in anal cancer: A systematic review / Frakulli R, Buwenge M, Cammelli S, Macchia G, Farina E, Arcelli A, Ferioli M, Fuccio L, Tagliaferri L, Galuppi A, Frezza GP, Morganti AG.. - In: JOURNAL OF CONTEMPORARY BRACHYTHERAPY. - ISSN 1689-832X. - ELETTRONICO. - 10:3(2018), pp. 246-253. [10.5114/jcb.2018.76884]

Brachytherapy boost after chemoradiation in anal cancer: A systematic review

BUWENGE, MILLY;Cammelli S;Arcelli A;Ferioli M;Fuccio L;Morganti AG.
2018

Abstract

Radio-chemotherapy (RCT) is the primary treatment of anal cancer (AC). However, the role and the optimal total dose of a radiation boost is still unclear. No randomized controlled trials nor systematic reviews have been performed to analyze the efficacy of brachytherapy (BRT) as boost in AC. Therefore, we performed this systematic review based on PRISMA methodology to establish the role of BRT boost in AC. A systematic search of the bibliographic databases: PubMed, Scopus, and Cochrane library from the earliest possible date through January 31, 2018 was performed. At least one of the following outcomes: local control (LC), loco-regional control (LRC), overall survival (OS), disease-free survival (DFS), or colostomy-free survival (CFS) had to be present for inclusion in this systematic review in patients receiving a BRT boost. Data about toxicity and sphincter function were also included. Ten articles fulfilled the inclusion criteria. All the studies had retrospective study design. All studies were classified to provide a level of evidence graded as 3 according to SIGN classification. Median 5-year LC/LRC, CFS, DFS, and OS were: 78.6% (range, 70.7-92.0%), 76.1% (range, 61.4-86.4%), 75.8% (range, 65.9-85.7%), and 69.4% (63.4-82.0%), respectively. The reported toxicities were acceptable. RCT is the treatment cornerstone in AC. High-level evidences from studies on BRT boost in AC are lacking. Further studies should investigate: efficacy of BRT boost in comparison to no boost and to external beam boost, patients who can benefit from this treatment intensification, and optimal radiation dose.
2018
Brachytherapy boost after chemoradiation in anal cancer: A systematic review / Frakulli R, Buwenge M, Cammelli S, Macchia G, Farina E, Arcelli A, Ferioli M, Fuccio L, Tagliaferri L, Galuppi A, Frezza GP, Morganti AG.. - In: JOURNAL OF CONTEMPORARY BRACHYTHERAPY. - ISSN 1689-832X. - ELETTRONICO. - 10:3(2018), pp. 246-253. [10.5114/jcb.2018.76884]
Frakulli R, Buwenge M, Cammelli S, Macchia G, Farina E, Arcelli A, Ferioli M, Fuccio L, Tagliaferri L, Galuppi A, Frezza GP, Morganti AG.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/645265
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