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According to results recently reported at the 2006 semi-annual meeting of the Radiation Therapy Oncology Group (RTOG), treatment including the chemotherapy agents 5-fluorouracil?and?mitomycin-C (Mutomycin?) plus?radiation therapy remains the standard of care for patients with anal cancer.

Anal cancer is a fairly uncommon cancer and refers to cancer originating at the end of the rectum. Depending on the stage of disease (extent of disease at diagnosis) and other factors, cancer of the anus may be treated with surgery, chemotherapy, and/or radiation therapy.

Treatment is aimed at a cure or improving the duration of survival, as well as maintaining the ability to control bowel function (fecal continence). A colostomy is sometimes required for patients with anal cancer if bowel function is lost; a colostomy is an opening created from the skin to the bowel to help dispose of waste. Treatment for anal cancer typically consists of surgery, chemotherapy, and/or radiation therapy.

The standard chemotherapy combination for the treatment of anal cancer has been mitomycin plus 5-FU. Researchers affiliated with RTOG recently conducted a clinical trial to directly compare mitomycin plus 5-FU to Platinol? (cisplatin) plus 5-FU in the hopes of improving outcomes among patients with anal cancer. This trial, referred to as the RTOG 98-11 study, was a phase III trial that included 632 patients who underwent surgery and radiation therapy with either 5-FU/mitomycin or 5-FU/Platinol.

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  • At five years, cancer-free survival was 59% for patients treated with 5-FU/mitomycin, compared with 53% for those treated with 5-FU/Platinol.
  • At five years, overall survival was improved by nearly 30% for patients treated with 5-FU/mitomycin compared to those treated with 5-FU/Platinol.
  • At five years, 90% of surviving patients treated with 5-FU/mitomycin did not require a colostomy, compared with 81% for those treated with 5-FU/Platinol.

The researchers concluded that 5-FU/mitomycin remains the standard of care in terms of chemotherapy for treatment of anal cancer. The authors stressed that the addition of targeted agents in combination with this regimen are the next step in improving outcomes for patients with anal cancer. Patients with anal cancer may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial evaluating new therapeutic regimens for the treatment of anal cancer.

Reference: Radiation Therapy Oncology Group. A Phase III Randomized Study of 5-Fluorouracil, Mitomycin-C, and Radiotherapy versus 5-Fluorouracil, Cisplatin and Radiotherapy in Carcinoma of the Anal Canal. Proceedings from the 2006 semi-annual meeting of the Radiation Therapy Oncology Group. June? 2006. Ontario, Canada.