Irradiation in the management of anal cancer with literature review.
Sixteen patients with a diagnosis of anal cancer were treated from 1981 to 1990 with combination of surgery, irradiation, and chemotherapy. Median age was 56 years (range 42 to 78 years). There were 3 males and 13 females. Fourteen patients were white and 2 were black. The stage of the primary was: T1-4, T2-9, T3-3. Eleven patients had the tumor in anal canal and 5 patients at the anal verge. Twelve patients had squamous cell carcinoma and 4 had cloacogenic carcinoma. Four patients had planned abdomino perineal resection (APR) after pre-operative chemotherapy (mitomycin C-15 mgm/m2 day 1; 5-fluorouracil, 750 mgm/m2, 24 hour infusion, days 1 to 5, repeated q15 days), and irradiation (30 gy in 15 fractions in 3 weeks). One patient had wide excision of the primary site after the pre-op chemotherapy and irradiation. Ten of 11 patients received higher dose of irradiation (45 to 55 Gy in 4 1/2 to 5 1/2 weeks, 5 days/week) in combination with chemotherapy and anal sphincter conservation surgery. One patient refused chemotherapy and was treated with surgery and high dose irradiation. The median follow-up was 28 months (range 3-125 months). Fifteen patients (94%) had local control. Thirteen are NED from 3 to 125 months and 2 died of intercurrent disease without cancer at 3 and 14 months. One patient with local recurrence at 9 months had salvage surgery, but died of disease. Except for moderate diarrhea and perineal reactions, there were no major complications.(ABSTRACT TRUNCATED AT 250 WORDS)
Jose
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Department of Radiation Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, KY 40292.
Lindberg
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Paris
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Spanos
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D000328:Adult; D000368:Aged; D001005:Anus Neoplasms / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged