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The benefit of concomitant mitomycin-based chemotherapy in patients with early stage nodenegative T1-T2N0 squamous cell carcinoma of the anal canal (SCCA) is poorly documented. It has been suggested that radiation therapy alone could be a good option in these patients.One hundred and forty-six patients with T1N0 (N = 27) or T2N0 (N = 119) SCCA were treated either by radiation therapy alone (71 patients, group RXT) or combined chemoradiation (75 patients, mitomycin C+ 5-fluorouracil, group CMT). Univariate and multivariate analysis were performed in order to assess patient-, tumour-, and treatment-related factors influencing loco-regional control (LRC) and overall survival (OS).After a median follow-up of 61 months, 124 patients (85%) were locally controlled. Actuarial LRC and OS for the whole population were 81% and 74%, respectively. 5-year LRC was 75% and 87% for patients in groups RXT and CMT, respectively (P = 0.15). 5-year cancer-specific survival was 85% and 95% in groups RXT and CMT, respectively (P = 0.17). Multivariate analysis showed that no clinical factors were found significantly to impact on LCR; by contrast, the addition of chemotherapy was of borderline significance (P = 0.06).In the management of early Stage SCCA, the addition of chemotherapy is associated with a trend towards better LCR.