Radiotherapy and chemotherapy in the conservative treatment of anal canal carcinoma.
OBJECTIVE
To evaluate the feasibility of conformal radiotherapy and concurrent chemotherapy in patients with anal canal carcinoma.


METHODS
Between 1990 and 2006, 83 patients affected by anal canal carcinoma were treated at the Radiotherapy Department of "La Sapienza" University of Rome. In all patients, a daily dose of 1.8 Gy, five times per week, was given for a total dose of 45 Gy for the whole pelvis (CTV1) and of 55-60 Gy for the tumor bed (CTV2). In 63 patients, chemotherapy consisted of two cycles of 5-fluorouracil (5-FU) and mitomycinC (MMC) or cisplatin delivery during the first and last week of radiotherapy.


RESULTS
The median follow-up time for all patients was 56.2 months. Treatment response was considered complete in 53 patients (63.8%) and partial in 30 patients (36.1%). Local tumor relapse was observed in 13 patients (15.6%). The probability of overall survival for all patients at 5 years was 75%: 39% in patients who underwent radiotherapy alone and 85% in patients who underwent radiochemotherapy (p=0.0013). Concerning acute toxicity, 9 patients developed grade 1 skin toxicity (10.8%), 35 grade 2 (42.1%), 26 grade 3 (31.3%) and 3 grade 4 (3.6%); eleven patients had grade 2 diarrhea (14.5%) and 2 grade 3 diarrhea (2.4%).


CONCLUSIONS
This analysis suggests that the treatment scheme employed was effective for anal sphincter preservation and local control.
Raffetto
Nicola
N
Radiotherapy Department, La Sapienza University, Rome, Italy.
Monaco
Alessia
A
Banelli
Enzo
E
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001005:Anus Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D016685:Mitomycin / Q000008:administration & dosage / Q000009:adverse effects; D009367:Neoplasm Staging; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies
D016685:Mitomycin; D002945:Cisplatin; D005472:Fluorouracil