Current management of anal canal cancer.


Journal Article (Review)

Squamous cell carcinoma of the anal canal historically has been treated with abdominoperineal resection, resulting in high rates of morbidity and local recurrence. Pioneering work led to the finding that radiation therapy (RT) combined with 5-fluorouracil (5-FU) and mitomycin results in high rates of local control and disease-free and colostomy-free survival without surgery. Prospective randomized trials from Europe and the United States have shown the superiority of RT, 5-FU, and mitomycin over 1) RT alone, 2) RT with 5-FU, and 3) neoadjuvant cisplatin/5-FU with concurrent radiation, cisplatin, and 5-FU. At present, RT with 5-FU and mitomycin is the standard of care for anal cancer patients. Recent advances include the integration of positron emission tomography into staging, radiation treatment planning and monitoring, and the use of intensity modulated RT. European randomized trials are further evaluating the role of cisplatin in the neoadjuvant, concurrent, and adjuvant settings, as well as radiation dose escalation. Other studies are evaluating the use of capecitabine, oxaliplatin, and the anti-epidermal growth factor receptor agent cetuximab with RT in this malignancy.

Full Text

Duke Authors

Cited Authors

  • Czito, BG; Willett, CG

Published Date

  • May 2009

Published In

Volume / Issue

  • 11 / 3

Start / End Page

  • 186 - 192

PubMed ID

  • 19336010

Pubmed Central ID

  • 19336010

Electronic International Standard Serial Number (EISSN)

  • 1534-6269

Digital Object Identifier (DOI)

  • 10.1007/s11912-009-0027-1


  • eng

Conference Location

  • United States