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Martinez-Cannon BA, Perez ACT, Hincapie-Echeverri J, Roy M, Marinho J, Buerba GA, Akagunduz B, Li D, Soto-Perez-de-Celis E. Anal cancer in older adults: A Young International Society of Geriatric Oncology review paper. J Geriatr Oncol 2022; 13:914-923. [DOI: 10.1016/j.jgo.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 02/07/2023]
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Raphael MJ, Ko G, Booth CM, Brogly SB, Li W, Kalyvas M, Hanna TP, Patel SV. Factors Associated With Chemoradiation Therapy Interruption and Noncompletion Among Patients With Squamous Cell Anal Carcinoma. JAMA Oncol 2021; 6:881-887. [PMID: 32324199 DOI: 10.1001/jamaoncol.2020.0809] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Definitive chemoradiation for anal cancer is effective but may be associated with toxic effects, and some patients may not be able to complete the planned treatment. Identifying factors associated with treatment interruption and noncompletion is important to target quality improvement efforts. Objective To identify rates of chemoradiation treatment interruption or noncompletion and factors associated with this among patients with anal cancer treated in routine clinical practice. Design, Setting, and Participants In this population-based, retrospective cohort study, the Ontario Cancer Registry was used to identify all incident cases of squamous cell anal cancer treated with curative-intent radiation from 2007 to 2015 in Ontario, Canada. Final analysis of data was performed on August 9, 2019. Exposures Curative-intent radiation therapy. Main Outcomes and Measures Treatment interruption was defined as more than 7 days between fractions of radiation. Radiation completion was defined as receipt of 45 Gy or more and 25 fractions of radiation. Chemoradiation completion was defined as radiation completion and 2 doses of combination chemotherapy. Associations between patient factors and treatment interruption and noncompletion were estimated with log-binomial models. Cox proportional hazard models were used to estimate the association of treatment interruption or noncompletion with all-cause death, cancer-specific death, and the combined outcome of colostomy or death. Results Overall, 1125 patients with stage I-III anal cancer were treated with curative-intent radiation. Treatment interruptions occurred in 262 (23%). Radiation and chemoradiation noncompletion occurred in 199 (18%) and 280 (25%), respectively. No associations were found to correlate with an increased risk of treatment interruption. Patients older than 70 years were less likely to complete chemoradiation (risk ratio [RR], 0.60; 95% CI, 0.52-0.70), compared with those younger than 50 years. Patients with a higher number of comorbidities were also less likely to complete chemoradiation (RR, 0.70; 95% CI, 0.51-0.95). Patients who did not complete chemoradiation had a higher risk of requiring salvage abdominoperineal resection (RR, 1.54; 95% CI, 1.03, 2.31), overall death (hazard ratio [HR], 1.54; 95% CI, 1.23-1.92), cancer-specific death (HR, 1.59; 95% CI, 1.14-2.22), and colostomy or death (HR, 1.80; 95% CI: 1.10-2.93). Treatment interruptions longer than 7 days were not associated with death. Conclusions and Relevance Many patients undergoing curative-intent chemoradiation for anal cancer experienced treatment interruption or noncompletion. Quality improvement initiatives to optimize treatment continuity and completion are needed.
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Affiliation(s)
- Michael J Raphael
- Sunnybrook Health Sciences Centre, Division of Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada
| | - Gary Ko
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada
| | - Christopher M Booth
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada.,Division of Medical Oncology, Department of Oncology, Queen's University, Kingston, Ontario, Canada.,International Credential Evaluation Service, Queen's, Kingston, Ontario, Canada
| | - Susan B Brogly
- International Credential Evaluation Service, Queen's, Kingston, Ontario, Canada.,Department of Surgery, Queen's University, Kingston, Ontario, Canada
| | - Wenbin Li
- International Credential Evaluation Service, Queen's, Kingston, Ontario, Canada
| | - Maria Kalyvas
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada.,Division of Radiation Oncology, Department of Oncology, Queen's University, Kingston, Ontario, Canada
| | - Timothy P Hanna
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada.,International Credential Evaluation Service, Queen's, Kingston, Ontario, Canada.,Division of Radiation Oncology, Department of Oncology, Queen's University, Kingston, Ontario, Canada
| | - Sunil V Patel
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada.,International Credential Evaluation Service, Queen's, Kingston, Ontario, Canada.,Department of Surgery, Queen's University, Kingston, Ontario, Canada
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Sourrouille I, Macovei R, Faron M, Le Péchoux C, Mir O, Adam J, Dumont S, Terrier P, Le Cesne A, Honoré C. Long-Term Outcome After Surgery for a Localized Retroperitoneal Soft Tissue Sarcoma in Elderly Patients: Results from a Retrospective, Single-Center Study. Ann Surg Oncol 2018; 25:2201-2208. [DOI: 10.1245/s10434-018-6529-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Indexed: 11/18/2022]
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Vallard A, Rancoule C, Guy JB, Assouline A, Falk AT, Auberdiac P, Langrand-Escure J, Chargari C, Magné N. Radiotherapy among nonagenarians with anal or rectal carcinoma: should we avoid or adapt treatment? CHINESE JOURNAL OF CANCER 2017; 36:56. [PMID: 28705218 PMCID: PMC5512941 DOI: 10.1186/s40880-017-0224-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 04/01/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Alexis Vallard
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 108 Bis, Avenue Albert-Raimond, BP 60008, 42271, Saint-Priest En Jarez, France
| | - Chloé Rancoule
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 108 Bis, Avenue Albert-Raimond, BP 60008, 42271, Saint-Priest En Jarez, France
| | - Jean-Baptiste Guy
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 108 Bis, Avenue Albert-Raimond, BP 60008, 42271, Saint-Priest En Jarez, France
| | - Avi Assouline
- Department of Radiotherapy, Porte De Saint Cloud Clinical Centre, 92100, Boulogne-Billancourt, France
| | - Alexander T Falk
- Department of Radiation Oncology, Antoine Lacassagne Centre, 06100, Nice, France
| | - Pierre Auberdiac
- Department of Radiotherapy, Claude Bernard Private Hospital, 81000, Albi, France
| | - Julien Langrand-Escure
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 108 Bis, Avenue Albert-Raimond, BP 60008, 42271, Saint-Priest En Jarez, France
| | - Cyrus Chargari
- Department of Radiotherapy, Val-De-Grâce Military Hospital, 75230, Paris, France
| | - Nicolas Magné
- Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 108 Bis, Avenue Albert-Raimond, BP 60008, 42271, Saint-Priest En Jarez, France.
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Vallard A, Guy JB, Espenel S, Langrand-Escure J, Trone JC, Méry B, Moriceau G, Rivoirard R, de Laroche G, Chargari C, Magné N. [Elderly patients and radiotherapy: A short review]. Bull Cancer 2015; 102:539-49. [PMID: 25840657 DOI: 10.1016/j.bulcan.2015.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 02/24/2015] [Accepted: 03/05/2015] [Indexed: 10/23/2022]
Abstract
The ageing of French population imposes to radiotherapists the challenge to treat older patients and to adjust their treatment. Unthinkable 30 years ago, radiation therapy concerns nowadays patients aged more than 90 years old. Oncogeriatric scales have been improved those last years without necessarily making sure that the right treatment is given to the right patient: if oncogeriatric scales use influences the final therapeutic decision, it does not define new target volumes, new doses, or new fractionation protocols. Except for some organs, there is not, for the moment, any consensus concerning geriatric population adapted treatments. This makes any therapeutic decision difficult. The present review has for objective to realise a report of the studies about favorable and unfavorable effects of radiation therapy amongst aged (>70 years old) or very aged (>90years old) population.
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Affiliation(s)
- Alexis Vallard
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Jean-Baptiste Guy
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Sophie Espenel
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Julien Langrand-Escure
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Jane-Chloé Trone
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Benoîte Méry
- Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Guillaume Moriceau
- Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Romain Rivoirard
- Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Guy de Laroche
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Cyrus Chargari
- Hôpital d'instruction des armées du Val-de-Grâce, département de radiation oncology, boulevard du Port-Royal, 75013 Paris, France
| | - Nicolas Magné
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France.
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Chargari C, Moriceau G, Auberdiac P, Guy JB, Assouline A, Eddekkaoui H, Annede P, Trone JC, Jacob J, Pacaut C, Bauduceau O, Vedrine L, Magne N. Analysis of Feasibility and Toxicity of Radiotherapy in Centenarians. J Am Geriatr Soc 2013; 61:1833-5. [DOI: 10.1111/jgs.12471] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Cyrus Chargari
- Medical and Radiation Oncology; Hôpital d'Instruction des Armées du Val-de-Grâce; Paris France
| | - Guillaume Moriceau
- Radiation Oncology; Institut de Cancérologie Lucien Neuwirth; Saint Priest en Jarez France
| | | | - Jean-Baptiste Guy
- Radiation Oncology; Institut de Cancérologie Lucien Neuwirth; Saint Priest en Jarez France
| | - Avi Assouline
- Radiation Oncology; Clinique de la Porte de Saint Cloud; Boulogne France
| | - Houda Eddekkaoui
- Radiation Oncology; Institut de Cancérologie Lucien Neuwirth; Saint Priest en Jarez France
| | - Pierre Annede
- Medical and Radiation Oncology; Hôpital d'Instruction des Armées du Val-de-Grâce; Paris France
| | - Jane-Chloé Trone
- Radiation Oncology; Institut de Cancérologie Lucien Neuwirth; Saint Priest en Jarez France
| | - Julian Jacob
- Medical and Radiation Oncology; Hôpital d'Instruction des Armées du Val-de-Grâce; Paris France
| | - Cécile Pacaut
- Radiation Oncology; Institut de Cancérologie Lucien Neuwirth; Saint Priest en Jarez France
| | - Olivier Bauduceau
- Medical and Radiation Oncology; Hôpital d'Instruction des Armées du Val-de-Grâce; Paris France
| | - Lionel Vedrine
- Medical and Radiation Oncology; Hôpital d'Instruction des Armées du Val-de-Grâce; Paris France
| | - Nicolas Magne
- Radiation Oncology; Institut de Cancérologie Lucien Neuwirth; Saint Priest en Jarez France
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