title: Conservative management of squamous cell carcinoma of the anal canal.
abstract: The treatment of anal carcinoma with concurrent chemo/radiotherapy has largely replaced abdominoperineal resection as the primary management. This report details the outcome of 62 patients with anal carcinoma treated at a single institution over a 10 year period, during which this approach has become the mainstay of therapy. Of the 34 patients treated with combination radiotherapy and chemotherapy (5-fluorouracil and mitomycin-C), 31 were evaluable and a complete response was achieved in 77%. The estimated 5 year failure-free survival was 67% and the overall survival was 81%. The overall survival was superior to that in patients treated with radiotherapy alone. Eighty-four per cent of patients received the treatment as planned, while the remainder had a reduction in the dose of radiation or chemotherapy due to acute toxicity. The use of combination therapy for primary management of anal carcinoma is generally well tolerated, appears to provide a treatment outcome at least equivalent to surgery, and allows preservation of anal function. Concurrent chemo/radiotherapy should be considered in the initial management of patients with anal carcinoma.
authors.affiliation: Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia.
authors.forename: R L
authors.initials: RL
authors.lastname: Basser
authors.forename: J G
authors.initials: JG
authors.lastname: Smith
authors.forename: V
authors.initials: V
authors.lastname: Worotniuk
authors.forename: M J
authors.initials: MJ
authors.lastname: Guiney
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / 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; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D016685:Mitomycin; D005472:Fluorouracil