Treatment of Localized Anal Cancer: Chemoradiotherapy

摘要: Prior to the 1980s, surgery was primary management of localized anal cancer. The concept chemoradiotherapy introduced in neoadjuvant setting prior abdominoperineal resection by Norman Nigro and colleagues at Wayne State University Hospital. Chemoradiotherapy with 5-fluorouracil, mitomycin C, radiation therapy yielded complete pathologic responses obviating need for upfront. Attempts have been made eliminate or change chemotherapy used original regimen attempts minimizing toxicity; however, these trials often compromised outcomes. Acute side effects reduced marked advancements delivery using intensity-modulated (IMRT) image guidance, where dose escalation is possible as a result effect profile. Using IMRT backbone, there are multiple ongoing developing clinical attempting improve efficacy treatment locally advanced disease.