PURPOSE: To identify prognostic factors and treatment @entity137 in a serie of epidermoid @entity5 of the anal canal without evident @entity3 . @entity1 AND METHODS: Between June 1972 and January 1997, 305 @entity1 (pts) were treated with curative-intent @entity1161 ( @entity1161 ). The T-stages according to the 1987 UICC classification were: 26 T1, 141 T2, 104 T3, and 34 T4. There were 49 pts with nodal involvement at presentation. Pretreatment anal function scoring according to our in-house system was: 22 scored 0, 182 scored 1, 74 scored 2, 7 scored 3, 11 scored 4, and 9 not available pts. The treatment started with external beam @entity1161 (EBRT) in 303 pts (median dose: 45 Gy). After a rest period of 4 to 6 weeks, a boost of 20 Gy was delivered by EBRT in 279 pts and by interstitial 192Ir brachytherapy (Bcy) in 17 pts. Seven pts received only one course of EBRT (mean dose: 49.5 Gy) and 2 pts were treated with interstitial 192Ir Bcy alone (55 and 60 Gy, respectively). Concomitant chemotherapy ( @entity1487 and either @entity1138 or @entity900 ) was delivered to 19 pts. Mean follow-up was 103 months. RESULTS: At the end of @entity1161 @entity5 clinical complete response (cCR) rate was 80%. Out of 61 non responders or local progressive @entity5 27 (44%) were salvaged with abdominoperineal resection (APR). The rate of @entity5 relapse (LR) was 12%. Out of 37 LTR, 20 (54%) were salvaged with APR and one with interstitial 192Ir Bcy. The orevall @entity5 control (LC) rate with or without salvage local treatment was 84%. LC rate with a good anal function scoring (score 0 and 1) was 56.5%. Among 181/186 available pts who preserved their anus, 94% had a good anal function scoring. For a subgroup of 15 pts with @entity5 <2 cm-N0, the LC rate after the end of @entity1161 was 100%, the LC rate with or without local salvage treatment was 100%, and among 13 available pts who preserved their anus, the anal function scoring was good in 12 pts (92%). The 10-years disease-free survival was 74%. After multivariate analysis, 3 independent predicting factors significantly influenced the disease-free survival: gap duration between 2 courses of @entity1161 (>38 days vs < or =38 days, P =0.0025), pretreatment anal function scoring (0 vs 1 vs 2 vs 3 vs 4, P =4.4 10(-6)), and cCR after the end of @entity1161 (no complete @entity6372 , P =2.5 10(-14)). CONCLUSION: We confirm excellent results with @entity1161 in T1 and T2 lesions. However, chemoradiotherapy should be prefered to improve survival free of colostomy with a good anal sphincter function for @entity5 more than or equal to 2 cm in length and locally advanced @entity5 .

[Epidermoid carcinomas of the anal canal treated with definitive @entity1161 in a series of 305 XXXX ].

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancers', 'length tumor', 'local tumor', 'tumors'] @entity1161 :: ('MESH:D011832', 'Disease') :: ['radiation therapy', 'RT'] @entity1138 :: ('MESH:D016685', 'Chemical') :: ['mitomycin C'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity6372 :: ('MESH:C538007', 'Disease') :: ['response vs complete response'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis'] @entity1487 :: ('MESH:D005472', 'Chemical') :: ['5-fluoro-uracil']
@entity1 :: (9606,Species) :: ['patients']
