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An alternative treatment of anal squamous cell carcinoma: Combined radiotherapy and chemotherapy
Author(s) -
You YauTong,
Wang JengYi,
Changchien ChungRong,
Chen JinnShiun,
Hsu Kuan Cheng,
Tang Reiping,
Fan HongArh
Publication year - 1993
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.2930520112
Subject(s) - medicine , abdominoperineal resection , radiation therapy , surgery , wide local excision , chemotherapy , anus , carcinoma , cancer , colorectal cancer
The conventional surgical treatment of anal squamous cell carcinoma is abdominoperineal resection. A new approach of combined radiotherapy and chemotherapy has been proposed following the observation of excellent local control. In this retrospective study, 40 cases of primary anal squamous cell carcinoma without distant metastasis were collected between 1979 and 1986 and the individual prognosis of the above two methods of treatment was evaluated. Group I (20 cases) received abdominoperineal resection with or without postoperative radiotherapy. Postoperative radiation was given if regional lymph node biopsy was positive. Group II (20 cases) received combined radiotherapy and chemotherapy with or without wide local excision. Radiation was delivered to the anus, pelvis, and bilateral inguinal nodal areas to a total dose of 5,500 rads. A continuous infusion of 5‐FU was started on day 2 of the irradiation at a dose of 1,000 mg/m 2 body surfaceiday for 5 days and a bolus injection of rnitomycin was given on day 2 at a dose of 10 mg/m 2 body surface. The second course was given 1 month later to complete the chemotherapy. The wide local excision was performed if the disease still persisted after completion of combined radiotherapy and chemotherapy. All 40 cases were followed up for at least 5 years. All cases (100%) in group I survived 1 year, 18 cases (90%) 2 years, 14 cases (70%) 3 years, 10 cases (50%) 4 years, and 6 cases (30%) 5 years. Twenty cases (100%) in group II survived 1 year, 17 cases (85%) 2 years, 13 cases (65%) 3 years, 8 cases (40%) 4 years, and 5 cases (25%) survived 5 years. All the mortalities in both groups died of distant metastasis or abdominal carcinomatosis. From the above results, the overall survival rate of combined radiotherapy and chemotherapy was not significantly worse than that of convential abdominoperineal resection. In conclusion, combined radiotherapy and chemotherapy may be chosen as an alternative management in treating anal squamous cell carcinoma. © 1993 Wiley‐Liss, Inc.