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Accurate determination of the tumor with the use of modern diagnostic methods which make the maximum exposure to the tumor and the identified affected lymph nodes possible lead to careful attitude to healthy tissues and critical structures. During the period 2000-2015 301 patients with squamous cell carcinoma of the anal canal stage T1-4N0-3M0-1 completed complex treatment which consisted of radiation therapy in a conventional or conformal mode, including the use of modern technologies - radiation therapy with intensity modulation - IMRT and arch volume-modulated radiation therapy - VMAT. The use of IMRT andVMAT in comparison with conformal radiation therapy allowed to reduce the frequency of unplanned interruptions up to 48 % (p = 0.005), which led to increase in 5-year rates of local regional control - 83.7 % compared with the group where the interruption was applied - 74.2 % (p = 0.049); also increased the frequency of complete responses in the range of the total dose of 50-54 Gy to 28.5 %, 56-58 Gy to 44.3 % and 60-64 Gy to 26.1 %. The achievement of a complete response led to a significant increase in the 92.1 % 5-year locoregional control compared to the group with the absence of a complete response - 76.5 % (p = 0.001). Modern conservative treatment is based on continuous radiation exposure with the absence of intervals between courses, which is the radiobiologically considered the most effective treatment regimen.

Introduction. 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.Purpose. One of the main tasks of improving technics and technology is reducting duration of chemoradiation therapy, and also number and duration of interruptions, plus more accurate determination of the tumor volume by using modern diagnostic methods, such as MRI, and creating the possibility of maximum impact on the tumor and identified affected lymph nodes while limiting dose to organs at risk.Materials and methods. During the period from 2000 to 2015 year, 301 patients with squamous cell anal carcinoma, stage T1–4N 0–3M0–1, were treated by radiation therapy with 2D-RT, 3D-CRT, or IMRT in a total dose of 50–60 Gy, in combination with chemotherapy and local hyperthermia.Results. The use of IMRT with MRI in comparison with 3D-CRT resulted in an increase of frequency of complete tumor response (at the time of first diagnostic control) up to 67.5 % (p = 0.071); reduction of frequency of interruptions in the treatment course up to 48 % (p = 0.005); significantly increased the 3-year overall survival rate to 92.9 % (p = 0.050), distant metastases — free survival — 91.0 % (p = 0.049), with a trend of improvement in locoregional control — 89.9 % (p = 0.179).Conclusions. The use of radiation therapy in its modern version, modern methods of visualization of tumor lesions and critical structures has reduced the interruptions in the course of treatment, achieved high immediate and long-term oncological results.

Late radiation injuries that occur after a significant period from the moment of completion of the radiation treatment can affect any anatomical structure within the irradiated area and thereby significantly impair the quality of life of cancer patients. Modern technologies of radiation therapy and scientifically based dose fractionation modes of radiation exposure have contributed to a significant reduction in the incidence of late radiation damage, but the risk of their appearance remains. The review presents literature data on both the treatment and the possibilities of drug prevention of late radiation damage, such as radio-induced soft tissue fibrosis.