Radiat Oncol J.  2015 Jun;33(2):83-88. 10.3857/roj.2015.33.2.83.

Can we omit prophylactic inguinal nodal irradiation in anal cancer patients?

• Kim H
• Park HC
• Yu JI
• Choi DH
• Ahn YC
• Kim ST
• Park JO
• Park YS
• Kim HC

• KMID: 2138877
• DOI: http://doi.org/10.3857/roj.2015.33.2.83

Abstract

PURPOSE
To evaluate the appropriateness of prophylactic inguinal nodal irradiation (PINI), we analyzed patterns of failure in anal cancer patients who were inguinal node-negative at presentation and did not receive PINI.
MATERIALS AND METHODS
We retrospectively reviewed the records of 33 anal cancer patients treated by definitive concurrent chemoradiation therapy (CCRT) between 1994 and 2013. Radiotherapy consisted of a total dose of 44-45 Gy (22-25 fractions in 5 weeks) on the whole pelvis, anus, and perineum. Except inguinal lymphadenopathy was present at initial diagnosis, the entire inguinal chain was not included in the radiation field. In other words, there was no PINI.
RESULTS
The median follow-up duration was 50 months (range, 4 to 218 months). Median survival and progression-free survival (PFS) were 57 months (range, 10 to 218 months) and 50 months (range, 4 to 218 months), respectively. Among the survival, the median follow-up duration was 51 months (range, 12 to 218 months). The 5-year overall survival and PFS rates were 93.4% and 88.8%, respectively. Although none of the patients received inguinal node irradiation for prophylactic purposes, there was no inguinal recurrence.
CONCLUSION
Treatment of anal cancer by omitting PINI might be considered in selected patients with clinically uninvolved inguinal nodes.

Keyword

Anus neoplasms; Prophylactic; Radiotherapy; Inguinal; Lymph nodes

MeSH Terms

Anal Canal
Anus Neoplasms*
Diagnosis
Disease-Free Survival
Follow-Up Studies
Humans
Lymph Nodes
Lymphatic Diseases
Pelvis
Perineum
Radiotherapy
Recurrence
Retrospective Studies