[Conservative treatment of the spinocellular cancer of the anal canal--a brief survey and report on 6 cases].

PURPOSE: The conservative treatment for carcinoma of the anal canal has become the standard care for this malignancy. In this report we want describe our curative protocol and our success on six cases treated by chemo-irradiation.

MATERIAL AND METHODS: Between February and December 2003 six female patients with UICC T2-3, No, Mo, G1-G2 squamous-cell carcinoma of the anal canal were treated. The disease was proved with digital examination, biopsy, endorectal ultrasound and spiral CT scan. The curative scheme included definitive irradiation by external beam radiation therapy and concomitant chemotherapy with Cisplatinum. The total tumor dose of 50.4 Gy, 1.8 Gy/day, 5 fractions weekly, was delivered to the pelvis and the primary tumor; for the inguinal lymph nodes the total dose was 41.4 Gy, 1.8 Gy/day, 5 fractions weekly. After interruption of 14 days, a local boost irradiation to the primary tumor was given--16 Gy, 2 Gy/day, 5 fractions weekly. Cisplatinum was given in days 1, 8, 15 and 22 of the radiotherapy, 35 mg/m2 daily, i.v. infusion. Complete tumor regression was obtained in all treated cases. With a median follow-up of 48 months all six patients are still alive, without signs of disease. The therapy was well tolerated, with good anal continence and moderate late side effects, including soft chronic diarrhea. Combined chemo-radiation with cisplatinum is associated with relatively low rate of acute toxicity.