Sphincter-conserving Treatment of Carcinomas of the Anal Margin

Abstract

Between Apri l 198 2 an d December 1997 24 patients with carcinoma of the anal margin were treated with radiation therapy (RT) (10patients) or RT-chemotherapy (CT) (14 patients). External bea m RT (EBRT) wa s delivered in 18 patients, combined with brachytherapyin 5 patients, while on e patient wa s treated with brachytherapy alone. Inguinal nodes were irradiated in 17 patients. Chemotherapy wasbase d on 5- ̄ uorouracil and mitomycin-C. At 5 years, the overall survival rat e was 56 % an d the locoregional rat e was 69.5%. Ana lsphincter was preserved in 16:24 treated patients. Grade 4 late complications wer e observed in 3 patients. This study reinforces the notiontha t radical RT9CT provides a high probability of cur e and sphincter preservation in patients presenting wit h this rare condition. Majorlate toxicity is uncommon; a better adaptation of treatment technique to the individual clinical situation may prevent some of the moresevere complications in the future.