CANCER OF THE ANAL-CANAL - TREATMENT WITH CHEMOTHERAPY AND LOW-DOSE RADIATION-THERAPY

PURPOSE: To determine the efficacy of a standardized protocol of chemo therapy and low-dose radiation therapy in treatment of patients with a nal canal cancer. MATERIALS AND METHODS: Forty-two consecutive patient s with anal canal cancer were treated with 15 fractions of 30-Gy photo n beam radiation therapy administered anteroposterior-posteroanterior in conjunction with chemotherapy with 5-fluorouracil and mitomycin C. Survival analysis was performed with the lifetest procedure. RESULTS: In patients with stage T1 and T2 tumors, 26 of 29 (90%) were free of d isease after chemotherapy and radiation therapy and had no recurrent t umors. In patients with stage T3 and T4 tumors, five of 13 (38%) were free of disease after therapy and had no recurrences. CONCLUSION: This therapy is effective for epidermoid cancers of the anal canal that ar e smaller than 5 cm regardless of nodal status. Tumors larger than thi s or that invade adjacent structures are not adequately controlled wit h this protocol.