ORIGINAL RESEARCH article
Front. Oncol.
Sec. Radiation Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1567655
Radio(chemo)therapy with curative intent for anal cancereffectiveness and toxicity in elderly vs. younger patients
Provisionally accepted
Mahalia Zoe Anczykowski1
Polina Rösel1
David Alexander Ziegler1,2Laura Anna Fischer1
Manuel Guhlich1
Rami A. El Shafie1
Stefan Rieken1
Leif Hendrik Dröge1
Martin Leu1*- 1Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Göttingen, Lower Saxony, Germany
- 2Medical University Lausitz - Carl Thiem, Department of Radiation Oncology and Radiotherapy, Cottbus, Germany
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Primary radio(chemo)therapy is a therapeutic standard strategy for advanced anal squamous cell carcinoma (ASCC). For elderly patients evidence concerning long-term oncological outcome is scarce.160 patients with advanced ASCC treated primarily by radio(chemo)therapy with curative intent were included. Baseline characteristics such as the Charlson Comorbidity Index as well as treatment-associated and long-term oncologic outcomes of patients with advanced (≥ 70 years) and younger (< 70 years) age were compared.Elderly patients had more comorbidities. They less frequently received concomitant chemotherapy. Acute enteritis ≥ III° and late pelvic bone fracture occurred more frequently in elderly patients. Overall survival and progression-free survival estimates were significantly lower for elderly patients, respectively (OS: HR 2.53, 95% CI 1.54-4.18; p < 0.001 and PFS: HR 2.10, 95% CI 1.29-3.42; p = 0.003). Locoregional and distant control did not show significant differences between elderly vs. younger patients.Primary radio(chemo)therapy seems to be an effective and relatively safe treatment option also in elderly patients. The lower overall and progression-free survival estimates as well as the negative survival influence of a higher comorbidity index strengthen the necessity to comprehensively weighing up and discuss potential benefits and side effects of primary radio(chemo)therapy. a Kruskal-Wallis test. b Pearson's Chi-squared test. c P-value of the Pearson's Chi-squared test calculated without patients with no data. Abbreviations: BMI, body mass index; CCI, Charlson Comorbidity Index; min, minimum; max, maximum; UICC, Union internationale contre le cancer; y, years of age. Acute organ toxicity ≥III° 66 41.3 47 39.8 0.54 a Dermatitis no 3 1.9 2 4.8 1 0.8 0.44 a I°
Keywords: Anal cancer, Primary treatment, Radiotherapy, elderly patients, geriatric oncology, comorbidities, Toxicity, Survival
Received: 27 Jan 2025; Accepted: 14 Apr 2025.
Copyright: © 2025 Anczykowski, Rösel, Ziegler, Fischer, Guhlich, El Shafie, Rieken, Dröge and Leu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Martin Leu, Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Göttingen, 37075, Lower Saxony, Germany
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