Anal squamous cell carcinoma (ASCC) is a rare malignancy with an increasing incidence despite advancements in treatment. The primary treatment for localized ASCC is radiochemotherapy (RCT), which achieves high rates of tumor regression in most cases, but up to 30% of patients experience recurrence or persistent disease. Salvage surgery, such as an abdominoperineal resection (APR), is often used for recurrent disease but is associated with significant morbidity and limited oncological outcomes. Patients with small T1 tumors may also benefit from primary local excision. For patients with metastatic or unresectable recurrent ASCC, chemotherapy, particularly carboplatin and paclitaxel, remains the standard treatment. New therapeutic strategies, including immune checkpoint inhibitors like pembrolizumab, are showing promise, particularly in PD-L1-positive tumors. Clinical trials have suggested that immunotherapy offers a potential alternative for patients for whom conventional treatments have failed, though the overall response rates remain modest. Re-radiation and intraoperative radiotherapy combined with salvage surgery may improve the outcomes for select patients, though the data are still limited. The management of recurrent or persistent ASCC requires a personalized approach, incorporating both established and emerging therapies to optimize patient outcomes. Further research is needed to refine these treatment strategies.
肛管鳞状细胞癌（ASCC）是一种罕见恶性肿瘤，尽管治疗手段不断进步，但其发病率仍在上升。局部ASCC的主要治疗方式是放化疗（RCT），该疗法在多数情况下可实现较高的肿瘤消退率，但仍有高达30%的患者出现复发或疾病持续存在。挽救性手术（如腹会阴联合切除术）常用于复发性疾病，但伴随显著并发症且肿瘤学疗效有限。小型T1肿瘤患者也可能从初次局部切除术中获益。对于转移性或不可切除的复发性ASCC患者，化疗（特别是卡铂联合紫杉醇方案）仍是标准治疗。包括帕博利珠单抗等免疫检查点抑制剂在内的新治疗策略显示出良好前景，尤其在PD-L1阳性肿瘤中。临床试验表明，对于传统治疗失败的患者，免疫疗法可能提供潜在替代方案，尽管总体缓解率仍有限。再程放疗及术中放疗联合挽救性手术可能改善特定患者的预后，但相关数据仍不充分。复发性或持续性ASCC的治疗需采取个体化策略，结合现有疗法与新兴疗法以优化患者预后。未来仍需进一步研究以完善这些治疗策略。
肿瘤(癌症)患者之家