A Population-Based Cohort Analysis of Chemoradiation Versus Radiation Alone for Definitive Treatment of Stage I Anal Cancer in Older Patients

Diseases of the Colon and Rectum
Michael BucksteinKeith Sigel

Abstract

Although the benefit of chemoradiation over radiation therapy alone has been shown in randomized trials for stage II to III squamous cell of the anus, this benefit is not clear for patients with stage I cancer. Nevertheless, most societal recommendations endorse chemoradiation for patients with stage I squamous cell carcinoma of the anus despite the lack of proven benefit and potential increase in toxicity. The purpose of this study was to determine whether outcomes are improved with the addition of chemotherapy versus radiation alone for stage I squamous cell carcinoma of the anus. This was a cohort analysis using Surveillance, Epidemiology and End Results registry linked to Medicare from 1996 to 2011. Propensity-score methods were used to control for potential confounding. This was a population-based study. Medicare eligible patients (age >65 y or with an eligible disability) with stage I squamous cell carcinoma of the anus treated with either definitive radiation alone or chemoradiation were included. Radiation or chemoradiation was the intervention. Overall survival, disease-free survival, cause-specific survival, colostomy-free survival, and acute or late toxicities were measured. A total of 200 patients with squamous cell...Continue Reading

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Citations

Jan 16, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Paolo GoffredoImran Hassan
Jan 25, 2021·International Journal of Colorectal Disease·Gaurav TalwarCagla Eskicioglu
Feb 8, 2021·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Ricardo N WernerFelix Aigner

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