Feasibility of non-surgical definitive management of anal canal XXXX .

@entity1 @entity7158 @entity66 @entity882 @entity75 @entity957 @entity1138 @entity294 @entity189 @entity1431 @entity1909
The management of anal canal @entity189 has evolved over the last decade, with the combination of radiotherapy (RT) and chemotherapy (CT) offering a definitive alternative to surgery or RT alone. Twenty-two @entity1 with basaloid/cloacogenic/ @entity957 of the anal (13 with @entity75 ), were treated with @entity7158 (30.00 to 45.00 Gy in 3 1/2 to 5 weeks) and CT X 2 courses ( @entity1138 15 mg/m2 I.V. bolus + 96 hours 5FU infusion). This regimen differed from the conventional Nigro regimen in that higher doses of RT and 2 courses of @entity1138 were used and both CT courses were given synchronously with RT. Three @entity1 with @entity66 were salvaged with an additional course of CT and local RT, without surgery. Acute side effects including perineal @entity1909 , @entity294 , @entity1431 , and @entity882 were reversible or transient. Twenty @entity1 are alive and free of disease 17 to 62 months (median 45 months) following initiation of treatment. Two @entity1 died at 7 months without evidence of disease at autopsy. These results compare favorably with other series employing RT alone, AP resection alone, and to those employing similar CT-RT regimens as well, in terms of disease-free survival rate (100%), complete response rate (19/22 or 86%), salvage rate without surgery (3/3), and acceptable morbidity. These results may be attributed to an optimal balance of RT and CT doses and refinements in RT technique which are detailed in our report.
