Modern intensity-modulated radiotherapy with image guidance allows low toxicity rates and good local control in chemoradiotherapy for anal cancer patients

Abstract

Modern intensity-modulated radiotherapy with daily image-guided radiotherapy is effective and safe in treating anal cancer patients and should be considered the standard of care in this clinical setting.

Patterns and Predictors of Relapse Following Radical Chemoradiation Therapy Delivered Using Intensity Modulated Radiation Therapy With a Simultaneous Integrated Boost in Anal Squamous Cell Carcinoma

“…[9][10][11] Comparison to other smaller IMRT series is difficult owing to the varying outcome definitions; however, 2-year, 3-year, and 4-year DFS is reported as 84.4%, 71%, and 82% in smaller published series. [28][29][30][31] In terms of patterns of relapse we can compare to the 4 retrospective cohorts of a 3D conformal technique, acknowledging that these publications reported different outcomes and definitions of outcomes. [32][33][34][35] Our LRR (19.5%) is similar to the 14.4% to 25% presented in these papers.…”

Neoadjuvant chemoradiotherapy delivered with helical tomotherapy under daily image guidance for rectal cancer patients: efficacy and safety in a large, multi-institutional series

“…This combination allows for a more precise definition of the planning target volume (PTV) and accurate irradiation. Dosimetric studies have shown that HT could reduce the doses delivered to the normal tissues in patients affected by lower gastrointestinal cancers (i.e., locally advanced rectal cancer or anal cancers) when compared with conventional 3D- conformal RT (De Bari et al 2018 ; Yang et al 2013 ) or IMRT (Yeung et al 2015 ). Clinical data on the role of HT in the treatment of locally advanced rectal cancer are available, but is mainly in the form of a small study which consisted of only a small cohort of 36 patients (Huang et al 2014 ).…”

Pooled Analysis of external-beam RADiotherapy parameters in phase II and phase III trials in radiochemotherapy in Anal Cancer (PARADAC)

“…Considering the impact of OTT on outcomes of combined therapy for anal cancer, strategies have been developed to shorten OTT while attempting to reduce toxicity. IMRT and VMAT have been proven to be feasible and current results show less skin, hematological and gastro-intestinal toxicity with comparable outcomes to results from 3D-conformal RT treatments [12][13][14]16,43]. These results should be interpreted with caution.…”

“…Despite attempts to improve this treatment, the standard treatment for locally advanced disease remained unchanged for years with the most recent contributions confirming the efficicacy of RT with 5-FU and MMC [7][8][9][10]. The most concrete improvement is the introduction of new modalities of RT delivery, Intensity Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT), allowing a better toxicity profile with comparable outcomes [11][12][13][14][15][16]. However, many questions remain a matter of debate.…”