International Journal of Radiation Oncology, Biology, Physics 11(9): 1587-1593, 1985.
For many years surgery has been the treatment of choice for squamous cell carcinoma of the anus, but it is now becoming apparent that well-planned definitive radiation therapy combined with chemotherapy may obviate the need for an abdomino-perineal resection. Since 1976, 33 patients with this disease were treated at Highland Hospital by radiation therapy combined with 5-FU and Mitomycin-C for sensitization. Four of these patients underwent a planned abdomino-perineal resection following therapy; the operative specimens of all four patients were negative for tumor. Twenty-nine patients were treated by the above method without surgery in a definitive manner and local control was achieved in 89.6% of patients. Radiation therapy combined with 5-FU and Mitomycin-C for sensitization has also been used in an effort to improve the resectability rate of large rectal cancers and ultimately the 5-year survival of patients with this disease. Fifty-eight patients with marginally resectable carcinoma of the rectum were treated pre-operatively by this regimen. The method of administration of the chemotherapeutic agents used for sensitization appears to be an important factor in obtaining an increased therapeutic ratio. Thirty-three patients have been followed for a minimum of 5 years with an 84.9% local control rate; 63.7% are alive and well, and 9.1% have died of intercurrent disease. An additional 22 patients have been treated with this regimen for recurrent rectal disease and 9.9% are alive and well at 5 years. Radiation therapy combined with 5-FU and Mitomycin-C for sensitization purposes appears to be effective in downstaging rectal carcinoma at surgery with a resultant survival rate superior to that following surgery alone.
Rheinische Friedrich- Wilhelms- Universität Bonn