title: The use of radiation therapy combined with chemotherapy in the management of squamous cell carcinoma of the anus and marginally resectable adenocarcinoma of the rectum.
abstract: For many years surgery has been the treatment of choice for squamous cell carcinoma of the anus, but it is now becoming apparent that well-planned definitive radiation therapy combined with chemotherapy may obviate the need for an abdomino-perineal resection. Since 1976, 33 patients with this disease were treated at Highland Hospital by radiation therapy combined with 5-FU and Mitomycin-C for sensitization. Four of these patients underwent a planned abdomino-perineal resection following therapy; the operative specimens of all four patients were negative for tumor. Twenty-nine patients were treated by the above method without surgery in a definitive manner and local control was achieved in 89.6% of patients. Radiation therapy combined with 5-FU and Mitomycin-C for sensitization has also been used in an effort to improve the resectability rate of large rectal cancers and ultimately the 5-year survival of patients with this disease. Fifty-eight patients with marginally resectable carcinoma of the rectum were treated pre-operatively by this regimen. The method of administration of the chemotherapeutic agents used for sensitization appears to be an important factor in obtaining an increased therapeutic ratio. Thirty-three patients have been followed for a minimum of 5 years with an 84.9% local control rate; 63.7% are alive and well, and 9.1% have died of intercurrent disease. An additional 22 patients have been treated with this regimen for recurrent rectal disease and 9.9% are alive and well at 5 years. Radiation therapy combined with 5-FU and Mitomycin-C for sensitization purposes appears to be effective in downstaging rectal carcinoma at surgery with a resultant survival rate superior to that following surgery alone.
mesh_terms: D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D001005:Anus Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin; D008937:Mitomycins / Q000627:therapeutic use; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*
chemical_list: D000903:Antibiotics, Antineoplastic; D008937:Mitomycins; D016685:Mitomycin; D005472:Fluorouracil