Intracavitary afterloading boost in anal canal carcinoma - Results, function and quality of life

Background: First clinical data on a new intracavitary afterloading boost m ethod for anal canal carcinoma is reported. Patients and Methods: 20 consecutive patients (T1 5%, T2 70%, T3 20%, T4 5% ; N0 75%, N1 10%, N2 15%; all MO) treated with external beam pelvic radioth erapy (median dose 56 Gy, range 46-64 Cy), simultaneous 5-FU and mitomycin (in 75%) and an intracavitary afterloading boost (one or two fractions of 5 Gy at 5 mm depth) were analyzed after a mean +/- SD follow-up for Living p atients of 4.4 +/- 2.1 years. Quality of Life (QoL) and anorectal manometry parameters were assessed in ten colostomy-free survivors. Results: Overall, recurrence-free and colostomy-free survival at 5 years we re 84%, 79% and 69%, respectively. No death was tumor-related. The only loc al failure was successfully salvaged by Local excision, All three colostomi es were performed for toxicity. Resting pressure and maximum squeeze pressu re of the anal sphincter were reduced by 51% and 71%, as compared with cont rol subjects, but quality of Life was similar compared to healthy volunteer s. Conclusion: The described regimen is highly effective but associated with i ncreased toxicity.