Journal of Hong Kong College of Radiologists

Volume 4 Number 1, 2001

Squamous Cell Carcinoma of the Anal Canal

1WM Mendenhall, 1SE Mitchell, 1RA Zlotecki, 2RR Carroll, 3EM Copeland III
1Department of Radiation Oncology, 2Division of Medical Oncology, and 3Department of Surgery,University of Florida College of Medicine, Gainesville, Florida, USA

The management of squamous cell carcinoma of the anal canal has been changed significantly over the last several decades. Treatment currently consists of radiotherapy (RT) alone or combined RT and chemotherapy, although some physicians occasionally employ abdominoperineal resection (APR) as the initial step in therapy. The pertinent literature is reviewed to determine the role of primary surgery, the efficacy of adjuvant chemotherapy, and the optimal chemotherapy schedule.

The preferred management of anal canal cancer is RT. Abdominoperineal resection should be reserved for salvage after local recurrence. Adjuvant chemotherapy is probably indicated for patients with lesions that are stage T2 or larger. The standard chemotherapy regimen consists of fluorouracil and mitomycin. Preliminary data suggest that cisplatin may be substituted for mitomycin with equivalent efficacy. (J HK Coll Radiol 2001;1:65-73)

Key words : Anus neoplasms, Chemotherapy, Radiotherapy, Squamous cell carcinoma, Surgery

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