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Gustavo Viani: New Evidence on Elective CTV in Early Anal Cancer

Gustavo Viani/sbradioterapia.com.br

Feb 21, 2025, 06:20

Gustavo Viani: New Evidence on Elective CTV in Early Anal Cancer

Gustavo Viani, Professor of Radiation Oncology at Ribeirão Preto Medical School, shared an article Joanna Sochaand and colleagues authored on X:

“New Evidence on Elective CTV in Early Anal Cancer!

Should we omit upper pelvic and external iliac LNs from elective radiotherapy? A new systematic review and meta-analysis suggests YES!

Objective:

•Assess risk of recurrence in untreated upper pelvic and external iliac LNs in cT1-2N0 anal cancer

Methods:

•9 studies (1 prospective, 8 retrospective)
•495 participants (upper pelvic LNs), 233 patients (external iliac LNs)
•Upper pelvic LN recurrence = failure above the sacroiliac joints without local recurrence

Results:

•Upper pelvic LN recurrence: 0.9% (95% CI: 0.1–1.8%)
•External iliac LN recurrence: 0%

Conclusion:

Omitting these LNs may decrease toxicity without increasing recurrence!”

Gustavo Viani: New Evidence on Elective CTV in Early Anal Cancer

Nina Niu Sanford, Assistant Professor and Chief of Gastrointestinal Radiation Oncology at Harvard/Brigham and Women’s Hospital/Massachusetts General Hospital, shared this post on X, adding:

“I also think we are over treating many early-stage anal cancers, since paradigms extrapolated from studies w mostly T3/4 N+ tumors.

DECREASE has finished accruing and will hopefully show de-escalation of RT dose/fields (superior border lowered to bottom of SI joint) is safe.”

Elective clinical target volume in early squamous cell anal canal cancer: A systematic review and meta-analysis of the risk of recurrence in untreated upper pelvic and external iliac lymph nodes

Authors: Joanna Socha et al.

Gustavo Viani: New Evidence on Elective CTV in Early Anal Cancer