# Radio(chemo)therapy with curative intent for anal cancer – effectiveness and toxicity in elderly vs. younger patients

## TL;DR

This study compares the effectiveness and side effects of radiotherapy and chemotherapy for anal cancer in elderly and younger patients.

## Contribution

The study provides evidence on long-term outcomes of radio(chemo)therapy in elderly patients with anal cancer.

## Key findings

- Elderly patients had more comorbidities and less frequent concomitant chemotherapy.
- Elderly patients experienced higher rates of acute enteritis and late pelvic bone fractures.
- Elderly patients had significantly lower overall and progression-free survival.

## Abstract

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.