RESUMEN
PURPOSE OF THE STUDY: The development of the rectum preservation treatment for the squamous-cell carcinoma of the anal canal. MATERIALS AND METHODS: The following scheme of the rectum preservation treatment for the squamous-cell carcinoma of the anal canal was developed and has been used in the Cancer Research Center RAMS since 1995. The irradiation is performed to the small pelvis, perineum and ilioinguinal lymph nodes, at a single dose 2 Gy, 22 sessions, total dose 44 Gy. Radiotherapy is associated with chemotherapy: cisplatin 20 mg/m2, twice a week, No 8; bleomycin 15 mg, twice a week, No 8. Irradiation is combined with 4-5 sessions of local hyperthermia. Local hyperthermia (about 42.5-43 degrees C in the tumor) was given for 60 minutes after irradiation. Local hyperthermia increases the effect of chemoradiotherapy in 1.5-2 times. If the tumor resorbtion exceeds 75%, intrarectal irradiation is performed at a single dose 3 Gy, 7-8 sessions, total dose 21-24 Gy. If the tumor resorbtion is less than 75%, abdomino-perineal resection is performed. RESULTS: This scheme was used in the treatment of 92 patients, rectum preservation treatment was performed in 76 cases (83%), abdomino-perineal resection--in 16 cases (17%). Local recurrences were in 10.0%, the overall 5-year survival was 75.2 +/- 8.5%.