Radiotherapy of Squamous Cell Carcinoma of the Anal Canal: Search for Optimal Solutions

The increase in the number of cured patients with squamous cell anal carcinoma and the quality of life is directly related to the improvement of radiotherapy departments technical equipment in oncological clinics. Main goals are more accurate determination of the tumor volume by using modern diagnostic methods, and creating the possibility of maximum impact on the tumor and identified affected lymph nodes while limiting dose to organs at risk. During the period from 2000 to 2015, 301 patients with squamous cell anal carcinoma, stage T1-4 N 0-3 M 0-1 , were complex treated by radiation therapy with 2DRT, 3DCRT, or IMRT/VMAT in a total dose of 50-60 Gy. The use of IMRT / VMAT in comparison with conformal radiation therapy allowed to improve: immediate results (complete tumor regression) 67.5 vs 55.6 % (p = 0.071) and 3-year long-term treatment results (overall survival) 92.9 vs 88.2 % (p = 0.05), respectively, with a tendency for the reliability of local-regional control 89.9 vs 81.6 % (p = 0.179). The use of radiation therapy in its modern version, using modern imaging methods allowed to achieve high immediate and long-term oncological results with the definition of the boundaries of the tumor lesion and summing the planned dose to the primary tumor and the affected lymph nodes.