Cancer Treatment

Previously it was thought that abdominoperineal resection leading to permanent colostomy was required for all except small anal tumors located below the dentate line, treatment with which about 70% of patients survived five years or more in institutions, but such surgery is no longer the preferred treatment. Radiation therapy alone may lead to a survival rate five years in more than 70%, although high doses (6,000 cGy or more) may cause necrosis or fibrosis. Chemotherapy concurrent with low-dose radiation therapy have led to a survival rate five years more than 70% with low level of acute and chronic morbidity, and few patients require surgery due to the toxic effects dermal or sphincter. Still being evaluated the optimal dose of radiation concurrent with chemotherapy to optimize local control and minimize sphincter toxic effects, but appears to be between 45 and 60 Gy. The analysis of a test between groups that compared radiation therapy plus fluorouracil / mitomycin with radiation therapy plus fluorouracil alone in patients with anal cancer has shown better results by adding mitomycin (lower colostomy rates and longer survival and disease-free colostomy). Radiation with continuous infusion of fluorouracil plus cisplatin is also under evaluation. The standard salvage therapy for patients with residual disease, either gross or microscopic chemoradiotherapy was followed by (more…)