Radiotherapy for Anal Cancer: Intensity-Modulated Radiotherapy and Future Directions

Surg Oncol Clin N Am. 2017 Jul;26(3):467-475. doi: 10.1016/j.soc.2017.01.004. Epub 2017 May 11.

Abstract

The treatment of anal cancer has evolved remarkably in the past 30 years. Definitive chemoradiotherapy is the standard of care, allowing organ preservation and maintenance of continence for most patients. This article reviews recent advances in radiotherapy planning and delivery that have resulted in improvements in treatment-related toxicity. Most notably, the advent and wide adoption of intensity-modulated radiotherapy provides a superior toxicity profile compared with older techniques, while maintaining similar oncologic outcomes. Current areas of active research include optimizing and individualizing treatment intensity and possible integration of biologic agents and immunotherapies in the treatment of anal cancer.

Keywords: Anal cancer; Antineoplastic agents; Anus neoplasms; Chemoradiotherapy; Intensity-modulated radiotherapy; Radiotherapy; Toxicity; Volumetric-modulated arc therapy.

Publication types

  • Review

MeSH terms

  • Anal Canal / pathology
  • Anal Canal / radiation effects*
  • Anus Neoplasms / pathology
  • Anus Neoplasms / radiotherapy*
  • Anus Neoplasms / surgery
  • Anus Neoplasms / therapy
  • Carcinoma, Squamous Cell
  • Chemoradiotherapy
  • Humans
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy, Intensity-Modulated / adverse effects*
  • Radiotherapy, Intensity-Modulated / methods*
  • Radiotherapy, Intensity-Modulated / trends
  • Treatment Outcome