Journal Article

DKFZ-2026-02264

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Outcomes of elderly patients treated with chemoradiotherapy for anal squamous cell carcinoma: a multicenter study of the German cancer consortium - radiation oncology group (DKTK-ROG)

Martin, D.DKFZ* ; Rödel, F.DKFZ* ; Kalinauskaite, G.DKFZ* ; Tinhofer, I.DKFZ* ; Zips, D.DKFZ* ; Gani, C.DKFZ* ; Schimek-Jasch, T.DKFZ* ; Schäfer, M.DKFZ* ; Grosu, A. L.DKFZ* ; Thomas, E.DKFZ* ; Krause, M.DKFZ* ; Dapper, H.DKFZ* ; Combs, S.DKFZ* ; Hoffmann, C.DKFZ* ; Stuschke, M.DKFZ* ; Walter, F.DKFZ* ; Belka, C.DKFZ* ; Kurth, I.DKFZ* ; Hadiwikarta, W. W.DKFZ* ; Baumann, M.DKFZ* ; Rödel, C.DKFZ* ; Fokas, E.DKFZ*

2026
Elsevier Amsterdam

Abstract: Background: Older patients with anal squamous cell carcinoma (ASCC) are underrepresented in prospective studies evaluating chemoradiotherapy (CRT). We evaluated patient−/tumor−/treatment characteristics and oncologic outcomes in older patients treated with CRT in a large retrospective multicenter cohort study of the DKTK-ROG. Materials and Methods: Patients with localized ASCC treated with CRT between 2004 and 2018, were retrospectively analyzed. Older patients were defined as age ≥ 70 years at CRT initiation. Freedom from recurrence (FFR) and overall survival (OS) were analyzed using Kaplan-Meier estimates, competing-risk analyses, and Cox regression models. Results: A total of 683 patients were analyzed, including 180 older patients (≥70 years, 26%). The 3-year FFR and OS rates for the entire cohort were 80.0% (95% CI, 76.9–83.3%) and 87.1% (95% CI 84.5–89.9%), respectively. Competing risk regression for locoregional failure including non complete response or distant metastases with death as competing risk revealed no significant difference between both groups (p = 0.5, p = 0.9, respectively). In contrast, older patients demonstrated inferior OS (p < 0.001). In multivariable analysis, advanced age remained associated with inferior OS (HR 2.51, 95% CI 1.73–3.64, p < 0.001), whereas no association between older age and FFR was observed (HR 1.04, 95% CI 0.69–1.58, p = 0.856); advanced T category and nodal involvement remained the dominant prognostic factors for worse FFR. Interpretation: Definitive CRT provides meaningful oncologic control in selected older patients with localized ASCC. Chronological age alone should not preclude curative-intent treatment. Future studies should integrate geriatric assessment to better individualize treatment strategies in older patients.

Note: #DKTKZFB26# / #NCTZFB26# / SCOPUS

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Contributing Institute(s):

1. DKTK Koordinierungsstelle Frankfurt (FM01)
2. DKTK Koordinierungsstelle Berlin (BE01)
3. DKTK Koordinierungsstelle Freiburg (FR01)
4. DKTK Koordinierungsstelle Dresden (DD01)
5. DKTK Koordinierungsstelle München (MU01)
6. DKTK Koordinierungsstelle Essen/Düsseldorf (ED01)
7. DKTK HD zentral (HD01)
8. Radioonkologie Radiobiologie (E220)
9. DKTK DD Translationale Radioonkologie (DD02)
10. Koordinierungsstelle NCT Dresden (DD04)

Research Program(s):

1. 315 - Bildgebung und Radioonkologie (POF4-315) (POF4-315)

Appears in the scientific report 2026

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Database coverage:
; ; Article Processing Charges ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DOAJ Seal ; Essential Science Indicators ; Fees ; IF < 5 ; JCR ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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