BACKGROUND: To report our results of anal canal carcinoma treatment with concomitant radiotherapy and chemotherapy. METHOD: From January 1992 to May 1998, 24 patients with anathomo-pathologic diagnosis of anal canal carcinoma were treated. Age ranged from 35 years old to 74 years old median of 59 years old. Female and male ratio was 3:1. The number of patients per stage was: I - 1, II - 13, III - 9 and IV - 1. Radiotherapy was delivered with doses of 45 Gy at the whole pelvis with 4 MeV Linear Accelarator followed by boost to the anal canal until 55Gy through direct field at Cobalt unit. Chemotherapy consisted of 5-FU (1000 mg/m²) and Mitomycin C (10 mg/m²) during the first and last five days of radiotherapy. RESULTS: The mean follow-up period was 34 months. Complete response was observed in 23 (95,8%) patients. Fourteen (58,3%) patients are alive with no cancer, 3 (12%) are alive with cancer, 5 (20,8%) died with cancer and 1 (4,2%) died with no evidence of cancer. Local recurrences occurred in 5 (20,8%) and distant metastasis in 4 (16,6%). All patients with local recurrence were salvaged with abdominal perineal ressection. Sphincter function was preserved in 18 (75%) patients. Acute and chronic complications were observed in 19 (79,2%) and in 9 (37,5%) patients, respectively. CONCLUSIONS: The treatment was effective in terms of local control and sphincter preservation, but a with high incidence of acute and late complications. Lower dose of radiation at the whole pelvis should be a reasonable approach to improve acute and late side effects. A larger number of patients and a longer follow-up will give more information about this treatment approach.
Carcinoma; Anal canal; Radiotherapy; Chemotherapy
