Abstract
Background: A retrospective study was conducted to evaluate sphincter function and quality of life (QoL) in patients treated with radiotherapy and concurrent chemotherapy (CRT) for anal canal cancer.
 Materials and Methods: From 1998 to 2010, patients with anal canal cancer treated with CRT were eligible. Radiation dose was 59.4 Gy (1.8 Gy/ fraction) and the chemotherapy regimen was 5-fluorouracil and mitomycin C. Anorectal function was investigated by anorectal manometry and transrectal ultrasound. QoL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C29 questionnaire. Correlations between diagnostic parameters and patient-reported outcomes were evaluated.
 Results: Eighteen patients were enrolled. Overall, 4 patients had stage I disease, 8 stage II and 6 stage III. Anorectal manometry parameters were significantly lower compared to healthy scores. Patients-reported continence was significantly higher than fecal incontinence manometry scores. Ultrasound sphincter complex defects were recorded in 17 patients. Globally, a positive correlation was described between resting pressure of manometric exam and sexual functioning items and sphincter complex and patient-reported flatulence, respectively.
 Conclusions: Definitive CRT represents the standard of care for anal canal cancer. Patients experienced low rates of fecal incontinence compared with results of diagnostic exams. Further studies are needed to better define toxicity and QoL after definitive CRT in anal canal cancer.
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