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Chemoradiation therapy is the standard of care in anal cancer. New modalities of radiation technique improve side effects. We analyze the clinical outcomes of patients diagnosed with anal cancer and treated with radiotherapy in our institution, comparing the use of different techniques.

Patients with histologically confirmed anal squamous cell carcinoma treated with radical radiotherapy from August 2001 to December 2020 were included. We created a database including the following variables: age, sex, histology, stage, radiotherapy dose and technique, toxicity and progression. We perform a descriptive study and we analyze overall survival (OS), disease-free survival (DFS) and colostomy free survival of our patients using Kaplan-Meier survival analysis. 

We included 52 patients. Staging according to The American Joint Committee on Cancer (AJCC) (7th edition) was: stage I 5,8%, stage II 30,8%, stage III 46.2%, stage IV 9,6%. 30 patients received 3D-CRT, 22 received IMRT or VMAT technique. No grade 4 acute toxicity occurred with IMRT-VMAT. 4% presented grade 4 acute toxicity with 3D-CTR. 10% presented chronic toxicity with 3D-CTR and 31.8% with IMRT or VMAT.

Median follow-up was 53.23 months. At 3-year follow-up the disease-free survival rate was 74,9% with 3DRT and 84.4% with IMRT-VMAT; and the overall survival rate was 76% with 3DRT and 77.4% with IMRT-VMAT. Colostomy free survival was 92.6% for 3DRT and 94.7% for IMRT-VMAT.

Local control and survival are very good with chemoradiotherapy and we have observed a trend towards less severe acute and chronic toxicity with IMRT-VMAT.