PMID- 26237193
OWN - NLM
STAT- MEDLINE
DCOM- 20171212
LR  - 20181202
IS  - 1537-453X (Electronic)
IS  - 0277-3732 (Linking)
VI  - 40
IP  - 6
DP  - 2017 Dec
TI  - Chemoradiation for High-grade Neuroendocrine Carcinoma of the Rectum and Anal
      Canal.
PG  - 555-560
LID - 10.1097/COC.0000000000000211 [doi]
AB  - OBJECTIVES: We evaluated outcomes in patients with high-grade neuroendocrine
      (HGNE) carcinoma of the anorectum treated with pelvic chemoradiation. MATERIALS
      AND METHODS: Between January 1, 2000 and February 17, 2013, 10 patients were
      confirmed to have HGNE carcinoma of the rectum or anal canal and treated with
      pelvic chemoradiation (radiation dose >/=45 Gy). Overall survival (OS),
      locoregional control (LRC), progression-free survival (PFS), and patterns of
      failure were evaluated. RESULTS: Eight had pure HGNE carcinoma and 2 had HGNE
      carcinoma with minor component of adenocarcinoma. Median age was 62 years. Median
      follow-up was 15 months (range, 3 to 128 mo). Tumor stages included TxN0M0 (1),
      II (1), III (4), and IV (4) including 2 with only inguinal involvement. Median
      tumor size was 5.5 cm (range, 3 to 7 cm). Patients received postoperative
      chemoradiation (1), preoperative chemoradiation (2), and chemoradiation without
      surgery (7). Median dose was 50.4 Gy (range, 45 to 60 Gy). All patients received 
      chemotherapy before or after chemoradiation. Seven had pelvic LRC; 2 had possible
      and 1 had confirmed local progression. Both patients who had preoperative
      chemoradiation only had microscopic focus of residual carcinoma at surgery. Seven
      had disease progression; of which all developed distant progression, with distant
      progression occurring as the first event in 6 (liver, lung, bone, and abdominal
      nodes). Actuarial 2-year PFS and OS were 30% and 46%, respectively. One patient
      received prophylactic cranial irradiation; only one of the other 9 patient
      developed brain metastasis. CONCLUSIONS: Pelvic chemoradiation provided LRC for
      the majority of the patients' lifetime. Most patients had distant failure, but
      patterns of distant failure do not support routine prophylactic cranial
      irradiation.
FAU - Voong, K Ranh
AU  - Voong KR
AD  - Departments of Radiation Oncology.
FAU - Rashid, Asif
AU  - Rashid A
AD  - Pathology.
FAU - Crane, Christopher H
AU  - Crane CH
AD  - Departments of Radiation Oncology.
FAU - Minsky, Bruce D
AU  - Minsky BD
AD  - Departments of Radiation Oncology.
FAU - Krishnan, Sunil
AU  - Krishnan S
AD  - Departments of Radiation Oncology.
FAU - Yao, James C
AU  - Yao JC
AD  - Medical Oncology.
FAU - Wolff, Robert A
AU  - Wolff RA
AD  - Medical Oncology.
FAU - Skibber, John M
AU  - Skibber JM
AD  - Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston,
      TX.
FAU - Feig, Barry W
AU  - Feig BW
AD  - Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston,
      TX.
FAU - Chang, George J
AU  - Chang GJ
AD  - Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston,
      TX.
FAU - Das, Prajnan
AU  - Das P
AD  - Departments of Radiation Oncology.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Clin Oncol
JT  - American journal of clinical oncology
JID - 8207754
RN  - 6804DJ8Z9U (Capecitabine)
RN  - 6PLQ3CP4P3 (Etoposide)
RN  - 7673326042 (Irinotecan)
RN  - BG3F62OND5 (Carboplatin)
RN  - Q20Q21Q62J (Cisplatin)
RN  - U3P01618RT (Fluorouracil)
RN  - XT3Z54Z28A (Camptothecin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anal Canal/surgery
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Anus Neoplasms/pathology/*therapy
MH  - Camptothecin/administration & dosage/analogs & derivatives
MH  - Capecitabine/administration & dosage
MH  - Carboplatin/administration & dosage
MH  - Carcinoma, Neuroendocrine/pathology/*therapy
MH  - Chemoradiotherapy/*methods
MH  - Cisplatin/administration & dosage
MH  - Consolidation Chemotherapy
MH  - Diarrhea/etiology
MH  - Digestive System Surgical Procedures
MH  - Disease-Free Survival
MH  - Etoposide/administration & dosage
MH  - Female
MH  - Fluorouracil/administration & dosage
MH  - Humans
MH  - Induction Chemotherapy
MH  - Irinotecan
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Neoadjuvant Therapy
MH  - Neoplasm Grading
MH  - Neoplasm Staging
MH  - Pelvis
MH  - Radiation Injuries/etiology
MH  - Radiodermatitis/etiology
MH  - Radiotherapy, Conformal/*methods
MH  - Radiotherapy, Intensity-Modulated/*methods
MH  - Rectal Neoplasms/pathology/*therapy
MH  - Rectum/surgery
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Tumor Burden
EDAT- 2015/08/04 06:00
MHDA- 2017/12/13 06:00
CRDT- 2015/08/04 06:00
PHST- 2015/08/04 06:00 [pubmed]
PHST- 2017/12/13 06:00 [medline]
PHST- 2015/08/04 06:00 [entrez]
AID - 10.1097/COC.0000000000000211 [doi]
PST - ppublish
SO  - Am J Clin Oncol. 2017 Dec;40(6):555-560. doi: 10.1097/COC.0000000000000211.