1998 Abstract: EFFICACY OF COMBINED CHEMO-RADIATION THERAPY FOR EPIDERMOID CARCINOMA OF THE ANAL CANAL FOR TUMORS LARGER THAN 5 CENTIMETERS. Peter S. Paik. Larry Leichman, Oscar Streeter Jr., Robert W. Beart Jr. Division of Colorectal Surgery, University of Southern California Medical Center, Los Angeles, California. 46
Abstracts 1998 Digestive Disease Week
#2337
EFFICACY OF COMBINED CHEMO-RADIATION THERAPY FOR EPIDERMOID CARCINOMA OF THE ANAL CANAL FOR TUMORS LARGER THAN 5 CENTIMETERS. Peter S. Paik. Larry Leichman, Oscar Streeter Jr., Robert W. Beart Jr. Division of Colorectal Surgery, University of Southern California Medical Center, Los Angeles, California.
Purpose: The purpose of this study was to assess the efficacy of a standardized protocol of combined radiation (30-45Gy) and chemotherapy (5-FU and mitomycinC) in the treatment of epidermoid carcinoma in the anal canal larger than or equal to 5 centimeter (T3 and T4 lesions). Material and Methods: From 1987 to 1997, 41 patients with epidermoid carcinoma in the anal canal without evidence of distant metastasis received combined chemo-radiation treatment as a primary therapy with curative intent. Local control and survival rates were compared in patients with tumor size less than 5cm (T1 and T2 lesions) with patients with tumor size equal or larger than 5cm (T3 and T4 lesions). The mean follow ups were 46 months for T1 and T2 lesions, and 64 months for T3 and T4 lesions. Result:
Local Control
before APR
Local Control
after APR
5 yr Survival
overall
T1 and T2
n = 20
85%
85%
90%
T3 and T4
n = 21
33%
(p < 0.05)
52%
86%
In patients with tumor size less than 5cm (T1 and T2 lesions), seventeen of twenty (85%) were free of disease after chemo-radiation therapy and had no recurrent tumors. In patients with tumor size larger than or equal to 5cm (T3 and T4 lesions), seven of twenty-one (33%) were free of disease after the treatment and had no recurrent tumors. In this group, significant improvement in local control rate was noted after salvage APR (33% vs. 52%). There was no significant difference in survival rates. Conclusions: Combined radiation and chemotherapy is effective in the treatment of epidermoid anal cancer with tumor size less than 5cm. Tumors larger than this or that invade adjacent structures, however, are not adequately controlled with this protocol. For these large tumors, treatment should be more aggressive to improve local control.
Copyright 1996 - 1998, SSAT, Inc. Revised 29 June 1998.
