This chapter will discuss the epidemiology, workup, staging, treatment recommendations, key studies, and radiation treatment techniques for anal cancer.
KeywordsAnal cancer Anal carcinoma High-grade anal intraepithelial lesions (HSIL) HPV and anal cancer HIV and anal cancer Radiation treatment for anal cancer
The authors thank Amy Gillis MD and Gautam Prasad MD, PhD for their work on the prior edition of this chapter.
- Bartelink H, Roelofsen F, et al. Concomitant radiotherapy and chemotherapy is superior to radiotherapy alone in the treatment of locally advanced anal cancer: results of a phase III randomized trial of the European Organization for Research and Treatment of Cancer Radiotherapy and Gastrointestinal Cooperative Groups. J Clin Oncol. 1997;15:2040–9.CrossRefPubMedGoogle Scholar
- Flam M, Madhu J, et al. Role of mitomycin in combination with fluorouracil and radiotherapy, and of salvage chemoradiation in the definitive nonsurgical treatment of epidermoid carcinoma of the anal canal: results of a Phase III Randomized Intergroup Study. J Clin Oncol. 1996;14:2527–39.CrossRefPubMedGoogle Scholar
- Glynne-Jones R, Sebag-Montefiore D, Meadows HM, et al. Best time to assess complete clinical response after chemoradiotherapy in squamous cell carcinoma of the anus (ACT II): a post-hoc analysis of randomised controlled phase 3 trial. Lancet Oncol. 2017;S1470-2045(17):30071–2.Google Scholar
- Gunderson LL, Winter KA, Ajani JA, et al. Long-term update of US GI intergroup RTOG 98-11 phase III trial for anal carcinoma: survival, relapse, and colostomy failure with concurrent chemoradiation involving fluorouracil/mitomycin versus fluorouracil/cisplatin. J Clin Oncol. 2012;30(35):4344–51.CrossRefPubMedPubMedCentralGoogle Scholar
- James R, Glynne-Jones D, Meadows HM, et al. Mitomycin or cisplatin chemoradiation with or without maintenance chemotherapy for treatment of squamous-cell carcinoma of the anus (ACT II): a randomised, phase 3, open-label, 2 × 2 factorial trial. Lancet Oncol. 2013;14:516–24.CrossRefPubMedGoogle Scholar
- 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
- National Cancer Institute Surveillance, Epidemiology, and End Results Program (SEER). https://www.seer.cancer.gov/statfacts/html/anus.html. Accessed 5 Dec 2016.
- National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology: Anal Carcinoma (Version 1.2017). https://www.nccn.org/professionals/physician_gls/pdf/anal.pdf. Accessed 5 Dec 2016.
- Salama JK, Mell LK, Schomas DA, et al. Concurrent chemotherapy and intensity-modulated radiation therapy for anal canal cancer patients: a multicenter experience. J Clin Oncol. 2007;29:4851–6.Google Scholar
- Wo JY, Hong TS, Callister MD, et al. Anal carcinoma. In: Gunderson LL, Tepper JE, editors. Clinical radiation oncology. 4th ed. Philadelphia: Churchill Livingstone; 2015. p. 1019–34.e4.Google Scholar