Radiation therapy in the management of epidermoid carcinoma of the anal region

Conclusion

Epidermoid carcinomas of the anal region may be treated by four procedures. Radiation plays a major role in the conservative management of these tumors. Lesions of the external margin may be treated satisfactorily by external irradiation with cobalt. It is possible to control a large number of anal carcinomas by fractionated interstitial Curie therapy. A combination of external irradiation and interstitial Curie therapy may be used to treat large and extensive lesions of the anal canal.

The aim of radiation therapy is not only to avoid mutilation and permanent colostomy, but also to remove the tumor completely while preserving anal function. To achieve this goal, treatment must be very carefully planned to avoid severe radio-necrosis.

For early and moderately advanced lesions, radium implant provides a satisfactory method of treatment.

In cases which do not respond satisfactorily to radiation, radical surgery still can be performed when the radiation therapy has been carefully planned and carried out, as the area treated is strictly limited to a definite volume and surrounding structures have not been subjected to irradiation.