Anal Cancer: Radiation Therapy Planning

Chapter

Abstract

Chemoradiation is the primary treatment for anal cancer. The goal of radiation therapy is to cover the primary tumor, involved lymph nodes, and at-risk regional lymph nodes. This chapter reviews radiation techniques, and principles of radiotherapy field design and treatment planning, for anal cancer.

Keywords

Anal Cancer Radiation Therapy Oncology Group Inguinal Node Ischiorectal Fossa Obturator Canal 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    National Cancer Institute: Surveillance E, and End Results Program. SEER Stat Fact Sheets: Anal Cancer. Available from URL: http://seer.cancer.gov/statfacts/html/anus.html. Accessed 20 Nov 2015.
  2. 2.
    Glynne-Jones R, Nilsson PJ, Aschele C, et al. Anal cancer: ESMO-ESSO-ESTRO clinical practice guidelines for diagnosis, treatment and follow-up. Radiother Oncol. 2014;111:330–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Shridhar R, Shibata D, Chan E, Thomas CR. Anal cancer: current standards in care and recent changes in practice. CA Cancer J Clin. 2015;65:139–62.CrossRefPubMedGoogle Scholar
  4. 4.
    Kim TH, Chie EK, Kim DY, et al. Comparison of the belly board device method and the distended bladder method for reducing irradiated small bowel volumes in preoperative radiotherapy of rectal cancer patients. Int J Radiat Oncol Biol Phys. 2005;62:769–75.CrossRefPubMedGoogle Scholar
  5. 5.
    Briere TM, Crane CH, Beddar S, et al. Reproducibility and genital sparing with a vaginal dilator used for female anal cancer patients. Radiother Oncol. 2012;104:161–6.CrossRefPubMedGoogle Scholar
  6. 6.
    Mitchell MP, Abboud M, Eng C, et al. Intensity-modulated radiation therapy with concurrent chemotherapy for anal cancer: outcomes and toxicity. Am J Clin Oncol. 2014;37:461–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Hood RC, Wu QJ, McMahon R, Czito B, Willett C. IMRT treatment of anal cancer with a scrotal shield. Med Dosim. 2012;37:432–5.CrossRefPubMedGoogle Scholar
  8. 8.
    Ajani JA, Winter KA, Gunderson LL, et al. Fluorouracil, mitomycin, and radiotherapy vs fluorouracil, cisplatin, and radiotherapy for carcinoma of the anal canal: a randomized controlled trial. JAMA. 2008;299:1914–21.CrossRefPubMedGoogle Scholar
  9. 9.
    Das P, Bhatia S, Eng C, et al. Predictors and patterns of recurrence after definitive chemoradiation for anal cancer. Int J Radiat Oncol Biol Phys. 2007;68:794–800.CrossRefPubMedGoogle Scholar
  10. 10.
    Cummings BJ, Keane TJ, O'Sullivan B, Wong CS, Catton CN. Epidermoid anal cancer: treatment by radiation alone or by radiation and 5-fluorouracil with and without mitomycin C. Int J Radiat Oncol Biol Phys. 1991;21:1115–25.CrossRefPubMedGoogle Scholar
  11. 11.
    Kachnic LA, Winter K, Myerson RJ, et al. RTOG 0529: a phase 2 evaluation of dose-painted intensity modulated radiation therapy in combination with 5-fluorouracil and mitomycin-C for the reduction of acute morbidity in carcinoma of the anal canal. Int J Radiat Oncol Biol Phys. 2013;86:27–33.CrossRefPubMedGoogle Scholar
  12. 12.
    Pepek JM, Willett CG, Wu QJ, Yoo S, Clough RW, Czito BG. Intensity-modulated radiation therapy for anal malignancies: a preliminary toxicity and disease outcomes analysis. Int J Radiat Oncol Biol Phys. 2010;78:1413–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Myerson RJ, Garofalo MC, El Naqa I, et al. Elective clinical target volumes for conformal therapy in anorectal cancer: a radiation therapy oncology group consensus panel contouring atlas. Int J Radiat Oncol Biol Phys. 2009;74:824–30.CrossRefPubMedGoogle Scholar
  14. 14.
    Taylor A, Rockall AG, Reznek RH, Powell ME. Mapping pelvic lymph nodes: guidelines for delineation in intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys. 2005;63:1604–12.CrossRefPubMedGoogle Scholar
  15. 15.
    Ng M, Leong T, Chander S, et al. Australasian Gastrointestinal Trials Group (AGITG) contouring atlas and planning guidelines for intensity-modulated radiotherapy in anal cancer. Int J Radiat Oncol Biol Phys. 2012;83:1455–62.CrossRefPubMedGoogle Scholar
  16. 16.
    Kim CH, Olson AC, Kim H, Beriwal S. Contouring inguinal and femoral nodes; how much margin is needed around the vessels? Pract Radiat Oncol. 2012;2:274–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Matthews JH, Burmeister BH, Borg M, et al. T1-2 anal carcinoma requires elective inguinal radiation treatment – the results of Trans Tasman Radiation Oncology Group study TROG 99.02. Radiother Oncol. 2011;98:93–8.Google Scholar
  18. 18.
    Ortholan C, Resbeut M, Hannoun-Levi JM, et al. Anal canal cancer: management of inguinal nodes and benefit of prophylactic inguinal irradiation (CORS-03 Study). Int J Radiat Oncol Biol Phys. 2012;82:1988–95.CrossRefPubMedGoogle Scholar
  19. 19.
    Hatfield P, Cooper R, Sebag-Montefiore D. Involved-field, low-dose chemoradiotherapy for early-stage anal carcinoma. Int J Radiat Oncol Biol Phys. 2008;70:419–24.CrossRefPubMedGoogle Scholar
  20. 20.
    Crowley C, Winship AZ, Hawkins MA, Morris SL, Leslie MD. Size does matter: can we reduce the radiotherapy field size for selected cases of anal canal cancer undergoing chemoradiation? Clin Oncol (R Coll Radiol). 2009;21:376–9.CrossRefGoogle Scholar
  21. 21.
    Zilli T, Betz M, Bieri S, et al. Elective inguinal node irradiation in early-stage T2 N0 anal cancer: prognostic impact on locoregional control. Int J Radiat Oncol Biol Phys. 2013;87:60–6.CrossRefPubMedGoogle Scholar
  22. 22.
    Brooks C, Hansen VN, Riddell A, Harris VA, Tait DM. Proposed genitalia contouring guidelines in anal cancer intensity-modulated radiotherapy. Br J Radiol. 2015;88:20150032.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Eleanor Osborne
    • 1
  • Christopher Crane
    • 2
  • Prajnan Das
    • 1
  1. 1.Department of Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of Radiation OncologyMemorial Sloan Kettering Cancer CenterNew YorkUSA

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