PURPOSE: The purpose of this study was to explore the dosimetric difference between simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) and three-dimensional conformal radiotherapy (3DCRT), and the clinical outcomes of anal squamous cell carcinoma (ASCC) chemoradiotherapy featuring SIB-IMRT. MATERIALS AND METHODS: This study included ten patients with ASCC who underwent chemoradiotherapy using SIB-IMRT with 5-fluorouracil and mitomycin C. SIB-IMRT delivered 54 Gy to each primary tumor plus metastatic lymph nodes and 45 Gy to regional lymph nodes, in 30 fractions. Four patients received additional boosts to the primary tumors and metastatic lymph nodes; the median total dose was 54 Gy (range, 54 to 60 Gy). We additionally created 3DCRT plans following the Radiation Therapy Oncology Group 9811 protocol to allow dosimetric comparisons with SIB-IMRT. Locoregional control, overall survival, and toxicity were calculated for the clinical outcome evaluation. RESULTS: Compared to 3DCRT, SIB-IMRT significantly reduced doses to the external genitalia, bladder, and intestine, delivering the doses to target and elective nodal region. At a median follow-up time of 46 months, 3-year locoregional control and overall survival rates were 88.9% and 100%, respectively. Acute toxicities were treated conservatively. All patients completed radiotherapy with brief interruptions (range, 0 to 2 days). No patient experienced ≥grade 3 late toxicity during the follow-up period. CONCLUSION: The dosimetric advantages of SIB-IMRT appeared to reduce the toxicity of chemoradiotherapy for ASCC achieving high locoregional control in the extended period.
Anus Neoplasms ; Carcinoma, Squamous Cell* ; Chemoradiotherapy ; Epithelial Cells* ; Fluorouracil ; Follow-Up Studies ; Genitalia ; Humans ; Intestines ; Lymph Nodes ; Mitomycin ; Radiotherapy ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Conformal ; Radiotherapy, Intensity-Modulated* ; Survival Rate ; Treatment Outcome ; Urinary Bladder

Iron deficiency in athletes induces negative effects on their athletic performances. The present study aimed to examine a possibility of non-invasive screening with urine ferritin value for iron deficiency by examining its association with serum ferritin value. A group of 30 male college soccer players,13 male endurance runners, 22 female volleyball players, and 9 female long distance runners voluntarily participated in this study. Blood samples were collected before breakfast. The urinary samples were collected to the special tube in the morning and analyzed by ELISA in accordance with the manufacture’s specification. The urinary ferritin value was significantly correlated with serum ferritin value (r=0.32, p<0.05). In addition, the corresponding association was improved in athletes whose urinary ferritin values were less than 2314 ng/gCre (n=52) (r=0.49, p<0.05). In each of male and female athletes, the results on the event-related differences in urinary ferritin had a similar trend as those on serum ferritin. In future studies, further testing should be accomplished using larger numbers of athletes for use the urine ferritin as non-invasive screening iron deficiency in athletes.