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!”
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.”
Authors: Joanna Socha et al.
