Martenson J A, Lipsitz S R, Lefkopoulou M, Engstrom P F, Dayal Y Y, Cobau C D, Oken M M, Haller D G
Mayo Clinic, Rochester, Minnesota 55905, USA.
Cancer. 1995 Nov 15;76(10):1731-6. doi: 10.1002/1097-0142(19951115)76:10<1731::aid-cncr2820761009>3.0.co;2-h.
This prospective study assessed combined modality therapy of patients with International Union Against Cancer classification T1-4 N0 M0 anal cancer.
Protocol therapy consisted of a dose of 4000 cGy to the pelvis, anus, and perineum, followed by a 1000-1300 cGy boost. Infusions of 5-fluorouracil and mitomycin-C were administered when radiation therapy began. A second infusion of 5-fluorouracil was administered 28 days later. Biopsy was performed 6-8 weeks after completion of treatment. Positive biopsy findings resulted in abdominal-perineal resection.
Survival at 7 years for 50 eligible patients was 58%. White patients and those with favorable performance status had significantly better survival. Of the 46 patients evaluable for response, 34 had a complete response, 11 had a partial response, and 1 had no response. Seven-year survival for partial responders was 53%. Freedom from locoregional progression was 80% at 7 years.
Treatment with a combination of chemotherapy and radiation therapy is effective for patients with anal cancer. The investigation of methods of improving therapy is warranted.
这项前瞻性研究评估了国际抗癌联盟（International Union Against Cancer）分类为T1 - 4 N0 M0的肛管癌患者的综合治疗方法。
方案治疗包括对骨盆、肛门和会阴给予4000 cGy的剂量，随后给予1000 - 1300 cGy的加强剂量。放射治疗开始时给予5-氟尿嘧啶和丝裂霉素-C静脉输注。28天后给予第二次5-氟尿嘧啶静脉输注。治疗完成后6 - 8周进行活检。活检结果阳性导致行腹会阴切除术。
50例符合条件的患者7年生存率为58%。白人患者和身体状况良好的患者生存率明显更高。在46例可评估反应的患者中，34例完全缓解，11例部分缓解，1例无反应。部分缓解患者的7年生存率为53%。7年时局部区域无进展率为80%。
化疗和放疗联合治疗对肛管癌患者有效。有必要对改进治疗方法进行研究。
