Please select the option that best describes you:
Topics:
Radiation Oncology • Gastrointestinal Cancers
Would you advocate for sphincter preserving chemoradiation therapy for a patient with a diagnosis of anal canal carcinoma who has previously been treated with pelvic radiation such as EBRT or brachytherapy?
How would your radiation treatment approach change in terms of dose and target definition?
Would the time interval between diagnosis affect the options?
Answer from: Radiation Oncologist at Academic Institution
The dose of the prior radiation is very important. If the sum is greater than 100Gy, there will be a risk of urinary or rectovaginal fistula formation. If the prior radiation was only adjuvant and there is a window of opportunity for definitive treatment. The acute reactions are no w...
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Answer from: Radiation Oncologist at Academic Institution
In the end, it will come down to the specific details of the prior radiation and how badly the patient wants to try to avoid a permanent colostomy. For patients who have received RT for prostate cancer, either with brachy or external beam, I would be very careful about the sum dose to the urethra an...