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Anal Canal Carcinoma Treatment Results: 10-year Experience in a Single Institution

肛門癌的治療結果:單一機構10年的臨床經驗

摘要


Purpose. The anal canal has a complex anatomy and histology and gives rise to various tumor types. Challenging issues remain in regard to both the pathologic diagnosis and the clinical management of these tumors. The aim of the retrospective study was to evaluate the clinical outcome in patients with anal cancer at a single institution. Methods. A retrospective data analysis was performed for patients with anal cancer treated in Taipei Medical University Hospital from 2008 to 2018. During this period, there were 23 patients diagnosed with anal cancer. Our analysis included data from hospital records, outpatient charts, and tumor registry data. Complete clinical responses, incomplete clinical responses, and recurrence were defined based on clinical, image and endoscopic findings. Results. There were 16 cases of anal squamous cell carcinoma, six cases of anal adenocarcinoma and only one case of well-differentiated neuroendocrine tumor. Follow-up information was available for 22 patients, with a mean follow-up period of 4.5 years (range, 1-10 years). To anal squamous cell carcinoma, the total complete response rate was 14/16 (87.5%), and the stage III cases complete response rate was 9/10 (90%). Three anal squamous cell carcinoma cases with complete response were recurrence. According to our data about all the anal squamous cell carcinoma cases, four patients with distant metastasis died after that. The 5- year survival rate of anal squamous cell carcinoma was 81.3%, and the 5- year survival rate of anal adenocarcinoma was 80%. There were six human Immunodeficiency virus anal squamous cell carcinoma patients with concurrent chemo-radiotherapy, and the complete response rate was 5/6 (83.3%). No obvious difference was found compared to non-human Immunodeficiency virus cases. Conclusions. To anal squamous cell carcinoma, 5-fluorouracil plus mitomycin C combined with radiotherapy leads to an outstanding clinical outcome, even in cases with human Immunodeficiency virus or stage III. Therefore, 5-fluorouracil plus mitomycin C chemotherapy combined with radiotherapy is the standard of care for all loco-regional anal cancer.

並列摘要


目的:肛門的腫瘤類型多樣是因為其複雜的組織學型態,目前對於這類腫瘤的病理診斷和臨床治療仍有些爭議。這篇回溯性研究的目的是分析單一機構對於肛門癌患者的臨床治療結果。方法:回溯性分析2008年至2018年台北醫學大學附屬醫院所收治的肛門癌患者的臨床資料。在此期間,有23個病人的診斷為肛門癌,我們針對病人的病歷記錄,門診就醫記錄和癌症中心的資料加以分析。根據病人的臨床症狀,影像學和大腸鏡的檢查結果來區分病人的治療情況,分類如下:完全有效和部分有效,且追蹤疾病是否有復發的情形。結果:肛門鱗狀細胞癌有16例,肛門腺癌有6例,分化好的神經內分泌腫瘤有1例。一共追蹤了22位患者,平均追蹤時間為4.5年(範圍為1-10年)。對於肛門鱗狀細胞癌,治療完全有效為14/16(87.5%),III期病例的治療完全有效率為9/10(90%)。在肛門鱗狀細胞癌治療完全有效的患者中有三例復發,全部肛門鱗狀細胞癌患者中有四位病人有遠端轉移並且死亡。肛門鱗狀細胞癌的5年生存率為81.3%,而肛門腺癌的5年生存率為80%。另外,肛門鱗狀細胞癌的患者中有六例病人患有人類免疫缺乏病毒,而這六個病人都有接受同步化學放射治療,治療完全有效率為5/6(83.3%)。與非患有人類免疫缺乏病毒的病患相比,沒有發現明顯差異。結論:對於肛門鱗狀細胞癌,同步化學放射治療(5-氟尿嘧啶加上絲裂黴素C)可獲得出色的臨床效果,即使在患有人類免疫缺乏病毒病患或III期患者中也是如此。因此,同步化學放射治療(5-氟尿嘧啶加上絲裂黴素C)是局部性肛門癌的治療標準。

並列關鍵字

肛門腺癌 肛門癌 鱗狀細胞癌

參考文獻


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