Combined chemotherapy and irradiation in anal canal carcinoma

Epidermoid anal canal carcinomas are radio- and chemosensitive tumors. With in a few decades, conservative treatment has replaced mutilating surgery as standard therapeutic practice. Exclusive high-dose radiotherapy remains th e standard treatment of early stages T1-T2 N0 smaller than 4 cm. Three phas e III trials demonstrated the benefits of combined chemotherapy and irradia tion on the local efficacy and colostomy-free survival. Mitomycine C and 5 FU were delivered on weeks 1 and 5 of the irradiation. Concomitant 5 FU and CDDP regimen and neoadjuvant chemotherapy were evaluated on phase II trial s. Ongoing intensification phase III trials are described. (C) 2000 Edition s scientifiques et medicales Elsevier SAS.