항문암의 동시 화학 방사선 요법 치료결과

Abstract

Among the 63 patients with histopathlogically proven primary squamous cell anal cancer who were managed in Prebyteriam Medical Center and Yonsei University Cancer from Jan. 1971 to Dec. 1991. 34 patients, who were managed with surgery alone(abdominoperineal resection) or post-operative radiotherapy and concurrent chemoradiotherapy were analysed. With mean follow up time of 81.3 months, 30 patients(88%) were followed up from 17 to 243 months. In methods, 10 patients were treated with surgery alone, 9 patients were treated with combined surgery and postoperative radiotherapy(50~60 Gy in 28~30 fractions). 15 patients were treated with concurrent chemoradiotherapy. Chomotherapy (Mitomycin c 15mg/squ, bolus injection day 1;5-FU, 750mg/squ, 24hr infusion, day 1 to 5) and radiotherapy started the same day. A dose of 30 Gy was given to the tumor and to the pelvis including inguinal nodes, in 15 fractions, After 2 weeks a boost of radiotherapy(20 Gy) to the ano-perineal area and second cycle of chemotherapy completed the treatment. The overall 5-year survival rate was 56.2%. Concurrent chemoradiotherapy group was 70% and surgery alone group was 16.7%. According to cox proportional harzard model, there was significant difference between survival with concurrent was 64.8%, which was not stastically significant(p=0.1412). In concurrent chemoradiotherapy group, the anal funtion preservation rate was 87% and the severe complication rate(grade 3 stenosis and incontinence) was 13.3%. In conclusion, we conclude that the concurrent chemoradiotherapy may be effective treatment modality in patients with anal cancer.