A Pattern of Care Report on the Management of Patients with Squamous Cell Carcinoma of the Anus—A Study by the Italian Association of Radiotherapy and Clinical Oncology (AIRO) Gastrointestinal Tumors Study Group
Pierfrancesco Franco,
Giuditta Chiloiro,
Giampaolo Montesi,
Sabrina Montrone,
Alessandra Arcelli,
Tiziana Comito,
Francesca Arcadipane,
Luciana Caravatta,
Gabriella Macchia,
Marco Lupattelli,
Marina Rita Niespolo,
Fernando Munoz,
Elisa Palazzari,
Marco Krengli,
Francesca Valvo,
Maria Antonietta Gambacorta,
Domenico Genovesi,
Giovanna Mantello
Affiliations
Pierfrancesco Franco
Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy
Giuditta Chiloiro
Fondazione Policlinico Universitario ‘Agostino Gemelli’ IRCCS, Via della Pineta Sacchetti, 00168 Rome, Italy
Giampaolo Montesi
Radiation Oncology Department, ‘S.M. Della Misericordia’ Hospital, AULSS 5 Veneto, Viale Tre Martiri 140, 45100 Rovigo, Italy
Sabrina Montrone
Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123 Pisa, Italy
Alessandra Arcelli
Radiation Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy
Tiziana Comito
Radiotherapy Department, Humanitas Clinical and Research Hospital IRCCS, Via Manzoni 56, Rozzano, 20089 Milan, Italy
Francesca Arcadipane
Department of Oncology, Radiation Oncology, AOU ‘Citta’ della Salute e della Scienza’, Via Cavour 31, 10123 Turin, Italy
Luciana Caravatta
Radiation Oncology Unit, ‘SS Annunziata Hospital’, ‘G. D’Annunzio’ University of Chieti-Pescara, Via dei Vestini, 66100 Chieti, Italy
Gabriella Macchia
Radiation Oncology Unit, Gemelli Molise Hospital–Universita’ Cattolica del Sacro Cuore, Largo Agostino Gemelli 1, 86100 Campobasso, Italy
Background and objectives: The diagnosis and therapy of squamous cell carcinoma of the anus may vary significantly in daily clinical practice, even if international guidelines are available. Materials and Methods: We conducted a pattern of care survey to assess the management of patients with anal cancer in Italy (38 questions). We analyzed 58 questionnaires. Results: Most of the respondents work in public and/or university hospitals (75.8%) in northern Italy (65.5%). The majority (88.0%) treat less than 20 patients/year. Common examinations for diagnosis and staging are anorectal endoscopy (84.5%), computed tomography scan (86.2%) and pelvic magnetic resonance imaging (MRI) (96.5%). The most frequently prescribed dose to primary tumor is 50–54 Gy (46.5–58.6%) for early stage disease and 54–59.4 Gy (62.1–32.8%) for locally advanced cases. Elective volumes are prescribed around 45 Gy (94.8%). Most participants use volumetric intensity modulated radiotherapy (89.7%) and a simultaneous integrated boost (84.5%). Concurrent radiotherapy, 5-fluorouracil and mitomycin is considered the standard of care (70.6%). Capecitabine is less frequently used (34.4%). Induction chemotherapy is an option for extensive localized disease (65.5%). Consolidation chemotherapy is rarely used (18.9%). A response evaluation is conducted at 26–30 weeks (63.9%) with a pelvic MRI (91.4%). Follow-up is generally run by the multidisciplinary tumor board (62.1%). Conclusions: Differences were observed for radiotherapy dose prescription, calling for a consensus to harmonize treatment strategies.
