A 10 Year Review of Anal Cancer Management in Northern Ireland
Descriptor
Review of practice over a 10 year period of management of anal cancer.
Background
Anal squamous cell cancer affects approximately 1100 patients in the UK annually.Outcomes for surgery and chemoradiotherapy (CRT) are comparable with CRT being the preferred modality to improve colostomy free survival. Large radiation pelvic fields can lead to increased acute toxicity and long term treatment related sequelae.
The Cycle
The standard:
Based on RCR guidance² & the ACT II trial³; time from consent to commencement of CRT <28days, completion of RT with <7 day delay; i.e. category 2 disease (100%), completion of radiotherapy (92%), completion of chemotherapy (75%), colostomy rate for treatment morbidity (<2%).Based on RCR guidance² & the ACT II trial³; time from consent to commencement of CRT <28days, completion of RT with <7 day delay; i.e. category 2 disease (100%), completion of radiotherapy (92%), completion of chemotherapy (75%), colostomy rate for treatment morbidity (<2%).
Target:
as above
Assess local practice
Indicators:
Adherence to the above Guidelines
Data items to be collected:
Patient demographics, tumour characteristics, treatment modality & clinical outcomes.
Suggested number:
All patients referred for management of their Anal Cancer
Suggestions for change if target not met
Set up an anal cancer working group
Resources
Cancer Online Information System (COIS)/patient notes/Radiotherapy systems/Audit Dept
References
-
Northern Ireland Cancer Registry as cited in cancer research UK website (27-02-2016) via: http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/anal-cancer/incidence.2.The timely delivery of radical radiotherapy: standards & guidelines for the management of unscheduled treatment interruptions, Third Edition, 2008. RCR.3.Mitomycin or cisplatin chemoradiation with or without maintenance chemotherapy for treatment of squamous-cell carcinoma of the anus (ACT II): a randomised, phase 3, open-label, 2 x 2 factorial trial. James RD et al. (2013) Lancet Oncol;14:516-24.
Submitted by
Dr G Corey
Co-authors
A J Cole
P M Bryson
D S Conkey
C Harrison
P G Henry
R F Houston
R M Park
R J A Harte