title: Sphincter-conserving treatment of carcinomas of the anal margin.
abstract: Between April 1982 and December 1997 24 patients with carcinoma of the anal margin were treated with radiation therapy (RT) (10 patients) or RT-chemotherapy (CT) (14 patients). External beam RT (EBRT) was delivered in 18 patients, combined with brachytherapy in 5 patients, while one patient was treated with brachytherapy alone. Inguinal nodes were irradiated in 17 patients. Chemotherapy was based on 5-fluorouracil and mitomycin-C. At 5 years, the overall survival rate was 56% and the locoregional rate was 69.5%. Anal sphincter was preserved in 16/24 treated patients. Grade 4 late complications were observed in 3 patients. This study reinforces the notion that radical RT +/- CT provides a high probability of cure and sphincter preservation in patients presenting with this rare condition. Major late toxicity is uncommon; a better adaptation of treatment technique to the individual clinical situation may prevent some of the more severe complications in the future.
authors.affiliation: Cantonal Department of Radiation Oncology, Oncology Institute of Southern Switzerland. sabine.bieri@hopsion.vsnet.ch
authors.forename: S
authors.initials: S
authors.lastname: Bieri
authors.forename: A S
authors.initials: AS
authors.lastname: Allal
authors.forename: J M
authors.initials: JM
authors.lastname: Kurtz
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000528:radiation effects*; D001005:Anus Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D002277:Carcinoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate