The progress in the treatment of anal canal cancer

Abstract

The incidence of anal cancer has increased significantly in the past few decades, and it will present a rising trend in the future. As for deeper understanding of the biological behavior of anal cancer, the treatment modality has changed. Primary treatment is no longer invasive surgical resection, concurrent chemo-radiotherapy could not only achieve the curative purpose, but also avoid the abdominal perineal resection of patients with poor quality of life. Concurrent chemo-radiotherapy as first-line treatment of anal cancer, which has been proven by many studies, is applied more and more widely. 5-fluorouracil and mitomycin C as concurrent chemotherapy regimen could improve the complete remission rate, sphincter preservation rate and disease-free survival rate. Residual tumor after concurrent chemo-radiotherapy could be treated by salvage surgery. The application of IMRT technology could improve the dosimetry of radiotherapy, while protecting the small intestine, bladder, skin and the femoral head to reduce the side effects of treatment, to minimize the interruption of treatment. Molecular targeted drugs added to the treatment of anal cancer has brought new options, but the effectiveness and safety of the combination need more results from more prospective studies. Key words: Anal canal; Treatment; Concurrent chemo-radiotherapy; Progress