What is the most appropriate radiation dose and volume for elderly and/or frail patients with advanced SCC of the anal canal not receiving chemotherapy to attain durable local control?  

Even for very debilitated cases, I have pushed the medical oncologists to give at least one cycle of 5FU (1gm/(m2-dy) X 4 Days) concurrently with RT.  For these cases I have reduced the treatment volume if possible and have been more inclined to give a treatment break. HIV positivity alone woul...

I agree with the above answers that radiation alone is totally appropriate, especially for older and sicker patients.  To add some evidence, we conducted a SEER-Medicare Analysis of T1N0 anal cancers treated with chemoradiation vs. RT alone (SEER-Medicare is the arguably the only way to get rea...

Radiation alone

Radiation alone would be a suitable option in this patient with outcomes dependent on lesion size (not stated). In the Mayo Clinic series of 18 patients reported by Martenson and Gunderson in 1993, 5-year local control was achieved in all patients (EBRT doses of 55-67 Gy, standard fractionation) and...

Dying of painful uncontrolled pelvic disease is horrible, so for patients who are elderly and frail but who will live long enough to require treamtent I would favor adding chemotherapy as @Robert J. Myerson stated. If the medical oncologist doesn't want to give full dose 5FU, then I would push ...