Question

Treatment of squamous cell carcinoma of the anal canal is:

• A. Cisplatin based chemotherapy followed by radical radiotherapy
• B. Abdominoperineal resection
• C. Radical radiotherapy
• D. Radical radiotherapy followed by mitomycin C based chemotherapy

Hint:

Anal canal SCC is cured with combined chemotherapy and radiotherapy, not surgery first; surgery is kept for salvage.

Answer 1

The Correct Option is A

Step 1: Think about what changed the treatment of this cancer.
Anal canal squamous cell carcinoma was once treated mainly by removing the anus and rectum. That changed once doctors found that chemotherapy paired with radiotherapy could destroy the tumor just as well while leaving the sphincter in place.

Step 2: Work out the correct order of treatment.
Chemotherapy is given first so the tumor cells become more sensitive to the radiation dose that follows. Starting with chemotherapy and then delivering radical radiotherapy is the working sequence behind this regimen.

Step 3: Test each remaining option against this idea.
Removing the anus and rectum surgically skips the sphincter sparing benefit entirely, so it is not the first choice anymore. Radiotherapy on its own drops the cure rate because it loses the chemical sensitizing effect. Placing the chemotherapy after the radical radiotherapy breaks the working order, since the sensitizing step needs to come first.

Step 4: Settle on the answer.
Only the option that starts with chemotherapy and follows with radical radiotherapy matches the accepted combined modality approach for this cancer.
$\boxed{\text{Chemotherapy followed by radical radiotherapy}}$