Abstract 233P
Background
ASCC is the predominant type in anal cancers and the incidence has been increasing in high-income countries including UK (Islami et al., 2017). It is radically treated with chemo-radiotherapy and the evolution of radiotherapy fractionation has been witnessed to achieve better outcomes (Dee et al., 2021). The current practice is by using IMRT protocol and it was implemented in Southend Hospital since 2013. This study is to look at our single centre 3-year outcome.
Methods
It is a retrospective data analysis of 62 patients treated at Southend hospital between September 2013 to July 2020 with a median follow up of 60 months.
Results
The median age was 60 years with a female to male ratio of 3:1. 60 patients (96.8%) completed the prescribed radiotherapy treatment in scheduled timeframe and 61 patients (98.39%) completed the concurrent chemotherapy. Three patients received Cisplatin rather than standard Mitomycin with 5-FU during temporary national Mitomycin shortage. 1-year, 2-year and 3-year disease free survival (DFS) were 90.32%, 82.26% and 78.69% respectively. For overall survival (OS), they were 93.54%, 83.87% and 79.03% respectively. We observed four loco-regional recurrences that were all in-field recurrence, seven distant recurrences and three persistent diseases which were evident at first assessment post completion of chemoradiotherapy. The median time for loco-regional recurrence was 17.5 (15-30) months. 75% of them had T4 disease and 50% had node positivity at presentation. For distant recurrence, the median timeline for recurrence was 14 (3-80) months and we observed the similar pattern of high proportion of T4 disease on presentation (42.86%) and 71.43% node positivity. However, for persistent diseases, there was no significant variation of T staging at presentation.
Conclusions
ASCC is a curable cancer, and the treatment is well tolerated. Most recurrences were big tumours (T4 disease) and node positive, at presentation, comparable to previously established studies (Ajani et al., 2010, Spehner et al., 2021). Therefore, our study supports the applied dose escalation for T3 and T4 or node positive disease as per current UK guidelines.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.