Combined chemotherapy and radiotherapy for carcinomas of the anus

Abdominoperineal resection (APR) has been the treatment of choice for squamous cell carcinoma of the anus; however, chemotherapy combined with radiotherapy (CT-RT) has now replaced APR as the primary treatment. Since 1983, 17 patients with carcinoma of the anus have been treated at Wenatchee Valley Clinic Tumor Center. Fourteen of these patients were treated with radiotherapy concurrently with administration of 5-fluorouracil (5-FU) and mitomycin C. Local control at 6 weeks post-treatment occurred in all 14 patients. Four of the 14 patients treated with CT-RT died, 2 of recurrent cloacogenic carcinoma, 2 of other cancers, and 1 of deep vein thrombosis. Five patients with stage III cancer were free of obvious disease at an average of 27 months follow-up. CT-RT seems to be successful for local control of anal carcinoma and, based on other studies, provides improvement in long-term survival when compared with APR.