RESULTS OF COMBINED-MODALITY THERAPY FOR PATIENTS WITH ANAL CANCER (E7283) - AN EASTERN-COOPERATIVE-ONCOLOGY-GROUP-STUDY

Background. This prospective study assessed combined modality therapy of patients with International Union Against Cancer classification T1- 4 NO MO anal cancer. Methods. Protocol therapy consisted of a dose of 4000 cGy to the pelvis, anus, and perineum, followed by a 1000-1300 cG y boost. Infusions of 5-fluorouracil and mitomycin-C were administered when radiation therapy began. A second infusion of 5-fluorouracil was administered 28 days later. Biopsy was performed 6-8 weeks after comp letion of treatment. Positive biopsy findings resulted in abdominal-pe rineal resection. Results. Survival at 7 years for 50 eligible patient s was 58%. White patients and those with favorable performance status had significantly better survival. Of the 46 patients evaluable for re sponse, 34 had a complete response, 11 had a partial response, and 1 h ad no response. Seven-year survival for partial responders was 53%. Fr eedom from locoregional progression was 80% at 7 years. Conclusion. Tr eatment with a combination of chemotherapy and radiation therapy is ef fective for patients with anal cancer. The investigation of methods of improving therapy is warranted.