Radiation therapy and chemotherapy in the conservative treatment of carcinoma of the anal canal: survival and late morbidity in a series of 25 patients.

Combined radiation therapy and chemotherapy have been reported to produce a high incidence of complete regression of epithelial cancer of the anal canal. Our group has treated 25 patients since June 1986. Treatment included chemotherapy (first period: Mitomycin C + 5-Fluorouracil; second period: Carboplatin + 5-Fluorouracil) and simultaneous whole-pelvis irradiation (50.40 Gy). Our results confirm that radiochemotherapy can achieve good local control: all patients were in complete clinical remission three months after the completion of combined therapy. Seven, patients developed recurrences; the actuarial survival rate was 78.5% and the disease free survival rate 67%. Acute toxicity was tolerable, but a relatively high number of patients exhibited chronic treatment-related symptoms. In order to reduce late side effects, other studies are necessary to explore if, in patients with small tumors, less extensive locoregional treatment can be effective without reducing the survival rate.