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Topics:
Radiation Oncology • Gastrointestinal Cancers
How would you treat a p16+ small cell neuroendocine tumor of the anal canal with or without metastatic inguinal lymph node metastasis?
What radiation doses would you use? Would the radiation dose and fields be the same as for squamous cell carcinoma? What chemotherapy would you recommend?
Answer from: Radiation Oncologist at Community Practice
Interesting case. Small cell cancers are generally considered radiosensitive, but so is anal squamous cell carcinoma. I personally would do the same RT field and dose. The real conundrum for me is the concurrent chemotherapy regimen - do you keep 5FU/MMC or do you use cisplatin/etoposide? I think a ...
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Answer from: Radiation Oncologist at Academic Institution
I agree. The extremely high DM risk should drive management. Extrapulmonary small cell neuroendocrine cancers all behave like the pulmonary ones. Although it is a rare histology and there is no definitive data, initial cis/etoposide followed by concurrent cis/etoposide IMRT with stand...