[Sphincter-preserving radiotherapy of anal carcinoma]

During the last decade radiotherapy, in combination with chemotherapy, has become the treatment of choice in cure of anal carcinoma with preservation of anal function, and has replaced abdominoperineal resection (APR). From 1979-1990 54 patients with anal carcinoma were treated by radiotherapy. 24 patients received radiotherapy after APR (12 adjuvant, 12 after recurrence). 11 received palliative radiotherapy without prior APR. 19 patients were treated curatively, 17 of whom received a combination of external irradiation followed by interstitial iridium implantation in a split course regimen. 11 of the 19 patients received short simultaneous chemotherapy (mitomycin C and 5-fluorouracil). All 19 patients had a complete remission. 18/19 patients had no local recurrence after mean 14 months' follow-up. 2 patients developed regional recurrence. 3 patients died of other causes. Colostomy was necessary in 5/19 patients with anal necrosis which was dose-related. The maximum tolerated dose was 71.4 Gy. Our results support the recommendation in the literature of primary, curative, radiotherapy and chemotherapy of anal carcinoma with preservation of the anal sphincter.