Journal article
Evolution of the Role of Radiotherapy for Anal Cancer
Cancers, Vol.13(6), pp.1-23
03/01/2021
DOI: 10.3390/cancers13061208
PMCID: PMC8001637
PMID: 33801992
Abstract
Simple Summary
Prior to the 1980s, primary management of localized anal cancer was surgery. Dr. Norman Nigro and colleagues found that neoadjuvant chemoradiotherapy with 5-fluorouracil and mitomycin C afforded complete response, obviating the need for surgery upfront. Advancements in radiotherapy delivery using intensity-modulated radiation therapy (IMRT) and image-guided radiation have resulted in reductions in radiation-associated adverse effects, allowing for the delivery of greater doses of radiation. Ongoing prospective trials are attempting to improve IMRT-based treatment of locally advanced disease with efforts to increase personalized treatment. Trials of newer modalities such as proton therapy are underway. In this review, we present the evolution of radiotherapy for anal cancer and describe recent advances to contextualize ongoing studies and inform future directions in efforts to mitigate treatment toxicities, further personalize treatment, and improve oncologic outcomes.
Prior to the 1980s, the primary management of localized anal cancer was surgical resection. Dr. Norman Nigro and colleagues introduced neoadjuvant chemoradiotherapy prior to abdominoperineal resection. Chemoradiotherapy 5-fluorouracil and mitomycin C afforded patients complete pathologic response and obviated the need for upfront surgery. More recent studies have attempted to alter or exclude chemotherapy used in the Nigro regimen to mitigate toxicity, often with worse outcomes. Reductions in acute adverse effects have been associated with marked advancements in radiotherapy delivery using intensity-modulated radiation therapy (IMRT) and image-guidance radiation delivery, resulting in increased tolerance to greater radiation doses. Ongoing trials are attempting to improve IMRT-based treatment of locally advanced disease with efforts to increase personalized treatment. Studies are also examining the role of newer treatment modalities such as proton therapy in treating anal cancer. Here we review the evolution of radiotherapy for anal cancer and describe recent advances. We also elaborate on radiotherapy's role in locally persistent or recurrent anal cancer.
Details
- Title: Subtitle
- Evolution of the Role of Radiotherapy for Anal Cancer
- Creators
- Edward Christopher Dee - Harvard UniversityJames D. Byrne - Harvard UniversityJennifer Y. Wo - Harvard University
- Resource Type
- Journal article
- Publication Details
- Cancers, Vol.13(6), pp.1-23
- DOI
- 10.3390/cancers13061208
- PMID
- 33801992
- PMCID
- PMC8001637
- NLM abbreviation
- Cancers (Basel)
- ISSN
- 2072-6694
- eISSN
- 2072-6694
- Publisher
- Mdpi
- Number of pages
- 24
- Language
- English
- Date published
- 03/01/2021
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiation Oncology
- Record Identifier
- 9984274857902771
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