Shifting paradigm in the management of anal canal carcinoma.

BACKGROUND

Anal canal is the lower most part of the gastrointestinal tract harbouring 4 % of all gastrointestinal cancer. Most common treatment for anal canal carcinoma includes chemoradiotherapy.

METHODOLOGY: We reviewed the recent landmark trials to find a road map in the management of anal canal carcinoma.

RESULTS

Concurrent chemoradiotherapy appears to be the most effective treatment schedule. Induction, as well as maintenance chemotherapy, has no definite role. Moderate dose radiation 50.4-54 Gy with concurrent mitomycin C (MMC) and 5-fluorouracil (5-FU) remains the standard. Split course is detrimental. Intensity-modulated radiotherapy and targeted drugs are investigated.

CONCLUSION

Combined modality therapy is the standard for anal canal carcinoma.