Abstract
Objective: to improve the results of treatment in patients with squamous cell carcinoma of the anal canal, by creating a new combination treatment option, and to increase the rate of organ-sparing treatment. Subjects and methods. A new combination treatment option for squamous cell carcinoma of the anal canal was created, which involved a combination of radiotherapy and a multiple radio modification program (ultrahigh-frequency (UHF) hyperthermia and local metronidazole (MZ) injection and systemic polychemotherapy) (RF patent No. 2427399 “A treatment option for squamous cell carcinoma of the anal canal” registered on 27 August 2011). To evaluate the created treatment option, the latter was analyzed in 157 patients with Т1–4N0–3M0 squamous cell carcinoma of the anal canal, who had been treated in 1990 to 2012. In 22 patients, radiotherapy was performed in combination with 3–5 sessions of local UHF hyperthermia (thermoradiotherapy (TRT)); 88 patients received the latter in combination with polychemotherapy (thermoradiochemotherapy (TRCT)); in addition to TRCT, 47 patients used MZ (TRCT + MZ). Results. In the TRT, TRCT, and TRCT + MZ groups, organ-sparing treatment was performed in 11 (50 %), 71 (80.7 %), and 44 (93.6 %) patients, respectively. In these groups, the median follow-up was 18.6; 51.7, and 15.5 months, respectively. In the 3 groups, the three-year overall survival rates were 71.4; 90.0, and 96.3 % and the three-year relapse free survival rates were 46.7; 60.6, and 75.0 %, respectively. Conclusion. The created combination thermochemoradiotherapy involving a polymer combination with MZ (TRCT + MZ) makes it possible to achieve organ-sparing treatment in 93.6 % of the patients and to slightly improve 3-year overall and relapse-free survival rates in patients with squamous cell carcinoma of the anal canal who have received organ-sparing treatment although there is only a tendency for statistical survival difference in this patient group.
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