Neoadjuvant chemotherapy followed by radiotherapy in epidermoid carcinoma of anus.
OBJECTIVE
The purpose of this study was to analyze the efficacy of neoadjuvant fluorouracil-cisplatin chemotherapy combined with radiotherapy for anal cancer.


METHODS
Fourteen patients with epidermoid carcinoma of the anal canal were analyzed. Treatment consisted of three cycles of 5-fluorouracil (1000 mg/m2 bolus on days 1-5) and cisplatin (60 mg/m2 bolus on day 1) followed by 50.4 Gy to the pelvis and perineum over 5.5 weeks. Both inguinal lymphatics were irradiated with an identical dose schedule. The median follow-up was 78 months.


RESULTS
Five-year overall survival rate and sphincter preservation rate was 85.1% and 85.7%, respectively. Response to chemoradiotherapy was the only significant factor with univariate analysis (P = 0.031). There were no complications of RTOG grade 3 or higher.


CONCLUSIONS
Neoadjuvant chemotherapy with a cisplatin-based regimen rather than concurrent regimen plus radiotherapy may decrease complications without compromising survival or sphincter preservation.
Department of Therapeutic Radiology, Seoul National University College of Medicine, Korea.
Eui Kyu
EK
Chie
Hong Gyun
HG
Wu
Dae Seog
DS
Heo
Yung-Jue
YJ
Bang
Noe Kyeong
NK
Kim
Sung W
SW
Ha
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001005:Anus Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy / Q000532:radiotherapy; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D016019:Survival Analysis; D016896:Treatment Outcome
D002945:Cisplatin; D005472:Fluorouracil