Rl. Basser et al., CONSERVATIVE MANAGEMENT OF SQUAMOUS-CELL CARCINOMA OF THE ANAL-CANAL, Australian and New Zealand journal of surgery, 64(11), 1994, pp. 754-758
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 t
reated at a single institution over a 10 year period, during which thi
s approach has become the mainstay of therapy. Of the 34 patients trea
ted 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 ove
rall survival was 81%. The overall survival was superior to that in pa
tients treated with radiotherapy alone. Eighty-four per cent of patien
ts received the treatment as planned, while the remainder had a reduct
ion in the dose of radiation or chemotherapy due to acute toxicity. Th
e 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 ma
nagement of patients with anal carcinoma.