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Carcinoma of the Anal Canal

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Gastrointestinal Malignancies

Part of the book series: Practical Guides in Radiation Oncology ((PGRO))

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Abstract

After three decades of phase III clinical trials, radiation with 5-fluorouracil (5-FU) and mitomycin-based chemotherapy remains the standard of care in the definitive management of squamous cell carcinoma of the anal canal. Despite the favorable disease-free survival with this organ-preserving approach, chemoradiation is associated with significant acute and late side effects. Moreover, local and distant failure remains a challenge in patients with large tumors or node-positive disease. Refinements in radiation planning and delivery with intensity-modulated radiation therapy (IMRT) have reduced the acute toxicity of chemoradiation, which allows for more patients to complete treatment without significant radiation breaks and for potential intensification of therapy in high-risk disease. This chapter will provide a detailed description of modern radio-chemotherapy delivery approaches for the treatment of anal canal cancer with an emphasis on practical considerations for the clinician.

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Authors and Affiliations

  1. University of Cincinnati, Cincinnati, OH, USA

    Jordan Kharofa M.D.

  2. Vanderbilt University Medical Center, Nashville, TN, USA

    Lisa Kachnic M.D., F.A.S.T.R.O. & Joseph Dunlap B.S., C.M.D.

  3. University of South Alabama, Mobile, AL, USA

    Clayton Smith M.D., Ph.D.

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  1. Jordan Kharofa M.D.
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  2. Lisa Kachnic M.D., F.A.S.T.R.O.
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  3. Clayton Smith M.D., Ph.D.
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  4. Joseph Dunlap B.S., C.M.D.
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Editors and Affiliations

  1. Department of Radiation Oncology, Case Western Reserve University, Cleveland, Ohio, USA

    Suzanne Russo

  2. Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida, USA

    Sarah Hoffe

  3. Department of Radiation Oncology, University of Washington School of Medicine, Seattle, Washington, USA

    Edward Kim

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Kharofa, J., Kachnic, L., Smith, C., Dunlap, J. (2018). Carcinoma of the Anal Canal. In: Russo, S., Hoffe, S., Kim, E. (eds) Gastrointestinal Malignancies. Practical Guides in Radiation Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-64900-9_13

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  • DOI: https://doi.org/10.1007/978-3-319-64900-9_13

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