Radiation therapy of anal epidermoid carcinoma |
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| Authors: | B Glimelius L P?hlman |
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| Affiliation: | 2. Zhejiang Provincial Clinical Research Center for Cancer, Cancer Center of Zhejiang University, Zhejiang, China;3. Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China;4. Department of Colorectal Surgery, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China;5. Department of Colorectal Surgery, Fujian Medical University Union Hospital, Fuzhou, China;11. Department of Colorectal Surgery, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China;12. Department of General Surgery, First Affiliated Hospital of Soochow University, Suzhou, China;8. Department of General Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, China;9. Department of Radiation Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China;2. Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;3. Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina;4. Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota;6. Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Australia;5. Department of Radiation Oncology, BC Cancer Vancouver Centre, Vancouver, British Columbia, Canada;11. Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada;12. Department of Radiation Oncology, University of California San Francisco, California |
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| Abstract: | Between 1978 and 1984, 44 consecutive patients with anal epidermoid carcinoma were either given radiation therapy alone (cloacogenic type) or in combination with Bleomycin (squamous type). The patients with small tumors (T1-T2) were treated to 65 Gy or 60 Gy + Bleomycin directly, whereas patients with moderately advanced tumors (T3) were treated to the same radiation dose, only if no evidence of residual disease existed after 50-55 Gy (40-45 Gy + Bleomycin); if a palpable tumor still remained 3 weeks after the irradiation, surgery was performed. Patients with tumors in Stage T4 were treated to 60-65 Gy (+/- Bleomycin) followed by surgery. The outcome has so far been excellent. All but four patients, treated according to the regimen and with no initial metastases, are alive and well; two died postoperatively, one developed urinary bladder recurrence, and one liver metastases. Nineteen patients have a preserved anal function. Only one of the 9 patients also treated with an abdomino-perineal excision had viable tumor at surgery. It is concluded that patients with an anal carcinoma can be safely treated with preservation of the anus in a significant proportion of the cases, and that a combined treatment approach most likely improves survival. |
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