Evolution of the Role of Radiotherapy for Anal Cancer
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 an...
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Online Access: | https://www.mdpi.com/2072-6694/13/6/1208 |
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doaj-a47899262ec14ba0aff40a627e465d7f2021-03-11T00:03:24ZengMDPI AGCancers2072-66942021-03-01131208120810.3390/cancers13061208Evolution of the Role of Radiotherapy for Anal CancerEdward Christopher Dee0James D. Byrne1Jennifer Y. Wo2Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USAHarvard Radiation Oncology Program, Harvard Medical School, Boston, MA 02115, USAHarvard Medical School, 25 Shattuck St., Boston, MA 02115, USAPrior 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.https://www.mdpi.com/2072-6694/13/6/1208chemoradiotherapy5-fluorouracilmitomycin Cintensity-modulated radiation therapyRTOG 0529Nigro regimen |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Edward Christopher Dee James D. Byrne Jennifer Y. Wo |
spellingShingle |
Edward Christopher Dee James D. Byrne Jennifer Y. Wo Evolution of the Role of Radiotherapy for Anal Cancer Cancers chemoradiotherapy 5-fluorouracil mitomycin C intensity-modulated radiation therapy RTOG 0529 Nigro regimen |
author_facet |
Edward Christopher Dee James D. Byrne Jennifer Y. Wo |
author_sort |
Edward Christopher Dee |
title |
Evolution of the Role of Radiotherapy for Anal Cancer |
title_short |
Evolution of the Role of Radiotherapy for Anal Cancer |
title_full |
Evolution of the Role of Radiotherapy for Anal Cancer |
title_fullStr |
Evolution of the Role of Radiotherapy for Anal Cancer |
title_full_unstemmed |
Evolution of the Role of Radiotherapy for Anal Cancer |
title_sort |
evolution of the role of radiotherapy for anal cancer |
publisher |
MDPI AG |
series |
Cancers |
issn |
2072-6694 |
publishDate |
2021-03-01 |
description |
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. |
topic |
chemoradiotherapy 5-fluorouracil mitomycin C intensity-modulated radiation therapy RTOG 0529 Nigro regimen |
url |
https://www.mdpi.com/2072-6694/13/6/1208 |
work_keys_str_mv |
AT edwardchristopherdee evolutionoftheroleofradiotherapyforanalcancer AT jamesdbyrne evolutionoftheroleofradiotherapyforanalcancer AT jenniferywo evolutionoftheroleofradiotherapyforanalcancer |
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