Combined Modality Treatment of Anal Carcinoma

  • W. Dobrowsky
  • E. Dobrowsky
Conference paper
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 110)

Abstract

There are two main problems in the treatment of anal cancer. Obviously, it is important to achieve local tumor control and a high survival rate, and, if possible, treatment should be conservative to retain normal anal function. This cancer should not be treated by surgery only or by percutaneous radiotherapy only for the following reasons:
  1. 1

    Anal carcinomas are accessible to interstitial radiotherapy.

     
  2. 2

    The tumor and lymph node secondaries are highyl radiosensitive but regression is slow.

     
  3. 3

    There is a high frequency of sequelae (radionecrosis) when the perineal region receives high doses of radiation.

     
  4. 4

    Permanent colostomy is necessary for a majority of surgically treated patients.

     

Keywords

Toxicity Cobalt Steam Oncol Diarrhea 

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References

  1. 1.
    Bagshaw MA (1961) Possible role of potentiators in radiation therapy. Am J Roentgenol 85:822–833Google Scholar
  2. 2.
    Beahrs OH (1979) Management of cancer of the anus. Am J Roentgenol 133: 790–795Google Scholar
  3. 3.
    Beahrs OH (1985) Management of squamous cell carcinoma of the anus and adenocarcinoma of the lower rectum. Int J Radiat Oncol Biol Phys 11: 1741–1742PubMedCrossRefGoogle Scholar
  4. 4.
    Buroker T, Nigro N, Considine B, Vaitkevicius VK (1979) Mitomycin C, 5-fluorouracil, and radiation therapy in squamous (epidermoid) cell carcinoma of the anal canal. In: Carter SK, Crooke ST (eds) Mitomycin C, current status and new developments. Academic, New York, pp 183–188Google Scholar
  5. 5.
    Byfield JE, Barone R, Mendelsohn J, Frankel S, Quinol L, Sharp T, Seagren S (1980) In-fusional 5-fluorouracil and X-ray therapy for non-resectable esophageal cancer. Cancer 45:703–708PubMedCrossRefGoogle Scholar
  6. 6.
    Cummings BJ (1982) The place of radiation therapy in the treatment of carcinoma of the anal canal. Cancer Treat Rev 9: 125–147PubMedCrossRefGoogle Scholar
  7. 7.
    Howell SB, Wung WE, Taetle R, Hussain F, Romine JS (1981) Modulation of 5-fluorouracil toxicity by a allopurinol in man. Cancer 48: 1281–1289PubMedCrossRefGoogle Scholar
  8. 8.
    John M, Flam M, Podolsky W, Ager Mowry P (1985) Feasibility of non-surgical definitive management of anal canal carcinoma (Abstr.) Int J Radiat Oncol Biol Phys 11 Suppl 1:109Google Scholar
  9. 9.
    Keane TJ, Harwood AR, Rider WD, Cummings BJ, Thomas GM (1984) Concomitant radiation and chemotherapy for squamous cell carcinoma (scc) esophagus. (Abstr.) Int J Radiat Oncol Biol Phys 10 Suppl 2: 89Google Scholar
  10. 10.
    Lo TCM, Wiley AL, Ansfield FJ, Brandenburg JH, Davis Jr HL, Gollin FF, Johnson RO, Ramirez G, Vermund H (1976) Combined radiation therapy and 5-fluorouracil for advanced squamous cell carcinoma of the oral cavity and oropharynx: a randomized study. Am J Roentgenol 126: 229–235Google Scholar
  11. 11.
    Maase von der H, Overgaard J (1985) Interactions of radiation and cancer chemo-therapeutic drugs in a C3H mouse mammary carcinoma. Acta Radiol [Oncol] 24: 181–187CrossRefGoogle Scholar
  12. 12.
    Newman HK, Quan SHQ (1976) Multi-modality therapy for epidermoid carcinoma of the anus. Cancer 37: 12–19PubMedCrossRefGoogle Scholar
  13. 13.
    Nigro ND, Vaitkevicius VK, Buroker T, Bradley GT, Considine B (1981) Combined therapy for cancer of the anal canal. Dis Colon Rect 24: 73–75CrossRefGoogle Scholar
  14. 14.
    Papillon J, Montbarbon JF, Ardiet JM, Pipard G (1987) Epidermoid carcinoma of the anal canal. Dis Colon Rect 30: 324–333CrossRefGoogle Scholar
  15. 15.
    Papillon J (1982) In: Rectal and anal cancers. Springer, Berlin Heidelberg New YorkCrossRefGoogle Scholar
  16. 16.
    Quan SHQ, Magill GB, Learning RH, Hajdu SI (1978) Multidisciplinary preoperative approach to the management of epidermoid carcinoma of the anus and anorectum. Dis Colon Rect 21: 89–91CrossRefGoogle Scholar
  17. 17.
    Quan SHQ (1979) Squamous cancer of the anorectum. (Abstr.) Int J Radiat Oncol Biol Phys 5: 63Google Scholar
  18. 18.
    Rauth AM, Mohindra JK, Tannock IF (1983) Activity of mitomycin C for aerobic and hypoxic cells in vitro and in vivo. Cancer Res 43: 4154–4158PubMedGoogle Scholar
  19. 19.
    Seifert P, Baker LH, Reed ML, Vaitkevicius VK (1975) Comparison of continuously infused 5-fluorouracil with bolus injection in treatment of patients with colorectal adenocarcinoma. Cancer 36:123–128PubMedCrossRefGoogle Scholar
  20. 20.
    Shank B (1985) Treatment of anal canal carcinoma. Cancer 55: 2156–2162PubMedCrossRefGoogle Scholar
  21. 21.
    Sischy B (1985) The use of radiation therapy combined with chemotherapy in the management of squamous cell carcinoma of the anus and marginally resectable adenocarcinoma of the rectum. Int J Radiat Oncol Biol Phys 11: 1587–1593PubMedCrossRefGoogle Scholar
  22. 22.
    Sischy B, Remington JH, Sobel SH, Sarlov ED (1980) Treatment of carcinoma of the rectum and squamous carcinoma of the anus by combination chemotherapy, radiotherapy and operation. Surg Gynecol Obstet 151: 369–371PubMedGoogle Scholar
  23. 23.
    Stearns MW, Quan SHQ (1970) Epidermoid carcinoma of the anorectum. Surg Gynecol Obstet 131: 953–957PubMedGoogle Scholar
  24. 24.
    Thomas G, Dembo A, Beale F, Bean H, Bush R, Herman J, Pringle J, Rawlings G, Sturgeon J, Fine S, Black B (1984) Concurrent radiation, Mitomycin C and 5-fluoroura-cil in poor-prognosis carcinoma of cervix: preliminary results of a phase I-II study. Int J Radiat Oncol Biol Phys 10: 1785–1790PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • W. Dobrowsky
    • 1
  • E. Dobrowsky
    • 1
  1. 1.Klinik für Radiotherapie und RadiobiologieUniversität WienWienAustria

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