What are the treatment protocols for salvage therapy in anal cancer?

Updated: Apr 07, 2020
  • Author: Jeffrey B VanDeusen, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

Answer

See the list below:

  • Salvage therapy may be needed for recurrent or persistent disease after the use of chemoradiotherapy.

  • Local recurrences may be successfully salvaged with surgery; however, locally recurrent anal squamous cell carcinoma poses a greater problem and higher rate of morbidity.

  • In a 1999 analysis of 185 patients who received either radiotherapy or chemoradiotherapy between 1976 and 1996, a total of 42 went on to develop local failure; 26 of these patients had salvage therapy consisting of abdominoperineal resection, and of these patients, 43% had long-term 5-y survival and control of their disease. [4]

  • Additionally, in the trial by Flam et al, 25 patients with positive post-treatment biopsies went on to receive salvage chemotherapy with cisplatin and 5-FU; 22 had subsequent biopsies, and 12 (55%) of the post-treatment biopsies in this setting were negative; 4 of 12 remained disease free at 4y. [3] Either cisplatin or 5-FU is an acceptable option; the choice depends on patient performance status and degree of local failure.


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