Revision as of 19:03, 1 January 2017

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9 regimens on this page 13 variants on this page

Guidelines

ESMO

Anal cancer: ESMO-ESSO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up PubMed

NCCN

NCCN Guidelines - Anal Carcinoma

Chemotherapy & radiation therapy

Fluorouracil, cisplatin, radiation therapy

Fluorouracil, cisplatin, radiation therapy for anal cancer

Fluorouracil, mitomycin, radiation therapy

Fluorouracil, mitomycin, radiation therapy for anal cancer

Radiation therapy

Radiation therapy for anal cancer

Chemotherapy

Fluorouracil & Cisplatin

Fluorouracil & cisplatin for anal cancer

@@ Line 21: / Line 21: @@
 {{:Fluorouracil, cisplatin, radiation therapy for anal cancer}}
-==Fluorouracil, mitomycin, radiation therapy {{#subobject:2 |Regimen=1}}==
+==Fluorouracil, mitomycin, radiation therapy==
-{| class="wikitable" style="float:right; margin-left: 5px;"
+{{:Fluorouracil, mitomycin, radiation therapy for anal cancer}}
-|-
-|[[#top|back to top]]
-|}
-===Regimen #1 {{#subobject:2 |Variant=1}}===
+==Radiation therapy==
-{| border="1" style="text-align:center;" !align="left"
+{{:Radiation therapy for anal cancer}}
-|'''Study'''
-|[[Levels_of_Evidence#Evidence|'''Evidence''']]
-|'''Comparator'''
-|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
-|-
-|[http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70086-X/abstract James et al. 2013 (ACT II)]
-|style="background-color:#00CD00"|Phase III
-|[[Anal_cancer#Fluorouracil.2C_cisplatin.2C_radiation_therapy|Fluorouracil, Cisplatin, radiation]]
-|style="background-color:#eeee00"|Seems not superior
-|-
-|}
-====Chemotherapy====
-*[[Fluorouracil (5-FU)]] 1000 mg/m<sup>2</sup>/day IV continuous infusion on days 1 to 4, 29 to 32
-*[[Mitomycin (Mutamycin)]] 12 mg/m<sup>2</sup> (maximum dose per cycle: 20 mg) IV bolus once on day 1
-*Concurrent radiation therapy: 1.8 Gy per day x 28 fractions (total dose: 50.4 Gy), given over 5.5 weeks; see paper for details
-'''5.5-week course'''
-''Patients were then randomized to maintenance cisplatin & fluorouracil vs. observation.''
-===Regimen #2 {{#subobject:3 |Variant=1}}===
-{| border="1" style="text-align:center;" !align="left"
-|'''Study'''
-|[[Levels_of_Evidence#Evidence|'''Evidence''']]
-|'''Comparator'''
-|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
-|-
-|[http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)03409-5/abstract UKCCCR Anal Cancer Trial Working Party 1996 (ACT I)]
-|style="background-color:#00CD00"|Phase III
-|[[Anal_cancer#Radiation_therapy|Radiation]]
-|style="background-color:#00CD00"|Superior local failure rate
-|-
-|}
-''Because there were a few different schedules used in UKCCCR Anal Cancer Trial Working Party 1996 and the update (Northover et al. 2010), there is some variability in potential schedules.''
-====Chemotherapy====
-*[[Fluorouracil (5-FU)]] 1000 mg/m<sup>2</sup>/day IV continuous infusion over 4 days (total dose for the week's treatment: 4000 mg/m<sup>2</sup>) during the first and last weeks of radiation therapy, '''started at least 2 hours before the first radiation fraction'''
-**Alternate dosing & schedule (per physician discretion): [[Fluorouracil (5-FU)]] 750 mg/m<sup>2</sup>/day IV continuous infusion over 5 days (total dose for the week's treatment: 3750 mg/m<sup>2</sup>) during the first and last weeks of radiation therapy
-*[[Mitomycin (Mutamycin)]] 12 mg/m<sup>2</sup> (maximum dose per cycle: 20 mg) IV bolus once on day 1
-*Concurrent radiation therapy: 1.8 or 2.25 Gy fractions x 20 or 25 fractions (total dose: 45 Gy), given over 4 to 5 weeks; see Northover et al. 2010 for details, including information about boost radiation therapy
-'''4 or 5-week course'''
-===Regimen #3 {{#subobject:4 |Variant=1}}===
-{| border="1" style="text-align:center;" !align="left"
-|'''Study'''
-|[[Levels_of_Evidence#Evidence|'''Evidence''']]
-|'''Comparator'''
-|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
-|-
-|[http://jama.ama-assn.org/content/299/16/1914.full Ajani et al. 2008 (RTOG 98-11)]
-|style="background-color:#00CD00"|Phase III
-|[[Anal_cancer#Fluorouracil.2C_cisplatin.2C_radiation_therapy|Fluorouracil, Cisplatin, radiation]]
-|style="background-color:#eeee00"|Seems not superior
-|-
-|}
-====Chemotherapy====
-*[[Fluorouracil (5-FU)]] 1000 mg/m<sup>2</sup>/day IV continuous infusion on days 1 to 4, 29 to 32
-*[[Mitomycin (Mutamycin)]] 10 mg/m<sup>2</sup> (maximum dose per cycle: 20 mg) IV bolus once per day on days 1 & 29
-*Concurrent radiation therapy; at a minimum: 1.8 Gy per day x 25 fractions (total dose: 45 Gy), given over 5 weeks; see article for additional details
-'''5-week course'''
-===References===
-# UKCCCR Anal Cancer Trial Working Party. UK Co-ordinating Committee on Cancer Research. Lancet. Epidermoid anal cancer: results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycin. Lancet. 1996 Oct 19;348(9034):1049-54. [http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)03409-5/abstract link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/8874455 PubMed]
-## '''Update:''' Northover J, Glynne-Jones R, Sebag-Montefiore D, James R, Meadows H, Wan S, Jitlal M, Ledermann J. Chemoradiation for the treatment of epidermoid anal cancer: 13-year follow-up of the first randomised UKCCCR Anal Cancer Trial (ACT I). Br J Cancer. 2010 Mar 30;102(7):1123-8. Epub 2010 Mar 16. [http://www.nature.com/bjc/journal/v102/n7/full/6605605a.html link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/20354531 PubMed] content property of [http://hemonc.org HemOnc.org]
-# Ajani JA, Winter KA, Gunderson LL, Pedersen J, Benson AB 3rd, Thomas CR Jr, Mayer RJ, Haddock MG, Rich TA, Willett C. Fluorouracil, mitomycin, and radiotherapy vs fluorouracil, cisplatin, and radiotherapy for carcinoma of the anal canal: a randomized controlled trial. JAMA. 2008 Apr 23;299(16):1914-21. [http://jama.ama-assn.org/content/299/16/1914.full link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/18430910 PubMed]
-# James RD, Glynne-Jones R, Meadows HM, Cunningham D, Myint AS, Saunders MP, Maughan T, McDonald A, Essapen S, Leslie M, Falk S, Wilson C, Gollins S, Begum R, Ledermann J, Kadalayil L, Sebag-Montefiore D. Mitomycin or cisplatin chemoradiation with or without maintenance chemotherapy for treatment of squamous-cell carcinoma of the anus (ACT II): a randomised, phase 3, open-label, 2×2 factorial trial. Lancet Oncol. 2013 May;14(6):516-24. [http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70086-X/abstract link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/23578724 PubMed]
-==Radiation therapy {{#subobject:3 |Regimen=1}}==
-{| class="wikitable" style="float:right; margin-left: 5px;"
-|-
-|[[#top|back to top]]
-|}
-===Regimen {{#subobject:5 |Variant=1}}===
-{| border="1" style="text-align:center;" !align="left"
-|'''Study'''
-|[[Levels_of_Evidence#Evidence|'''Evidence''']]
-|'''Comparator'''
-|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
-|-
-|[http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)03409-5/abstract UKCCCR Anal Cancer Trial Working Party 1996 (ACT I)]
-|style="background-color:#00CD00"|Phase III
-|[[Anal_cancer#Fluorouracil.2C_mitomycin.2C_radiation_therapy|Fluorouracil, Mitomycin, radiation]]
-|style="background-color:#ff0000"|Inferior local failure rate
-|-
-|}
-''Inferior to combined modality therapy; included for reference purposes only.''
-===References===
-# UKCCCR Anal Cancer Trial Working Party. UK Co-ordinating Committee on Cancer Research. Lancet. Epidermoid anal cancer: results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycin. 1996 Oct 19;348(9034):1049-54. [http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)03409-5/abstract link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/8874455 PubMed]
-## '''Update:''' Northover J, Glynne-Jones R, Sebag-Montefiore D, James R, Meadows H, Wan S, Jitlal M, Ledermann J. Chemoradiation for the treatment of epidermoid anal cancer: 13-year follow-up of the first randomised UKCCCR Anal Cancer Trial (ACT I). Br J Cancer. 2010 Mar 30;102(7):1123-8. Epub 2010 Mar 16. [http://www.nature.com/bjc/journal/v102/n7/full/6605605a.html link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/20354531 PubMed]
 =Chemotherapy=
-==Fluorouracil & Cisplatin {{#subobject:4 |Regimen=1}}==
+==Fluorouracil & Cisplatin==
-{| class="wikitable" style="float:right; margin-left: 5px;"
+{{:Fluorouracil & cisplatin for anal cancer}}
-|-
-|[[#top|back to top]]
-|}
-===Regimen {{#subobject:6 |Variant=1}}===
-{| border="1" style="text-align:center;" !align="left"
-|'''Study'''
-|[[Levels_of_Evidence#Evidence|'''Evidence''']]
-|-
-|[http://www.jle.com/en/revues/medecine/bdc/e-docs/00/01/12/15/resume.phtml Faivre et al. 1999]
-|style="background-color:#ff0000"|Pilot, <20 patients reported
-|-
-|}
-====Chemotherapy====
-*[[Fluorouracil (5-FU)]] 1000 mg/m<sup>2</sup>/day IV continuous infusion on days 1 to 5
-*[[Cisplatin (Platinol)]] 100 mg/m<sup>2</sup> IV once on day 2
-'''28-day cycles'''
-===References===
-# Faivre C, Rougier P, Ducreux M, Mitry E, Lusinchi A, Lasser P, Elias D, Eschwege F. [5-fluorouracile and cisplatinum combination chemotherapy for metastatic squamous-cell anal cancer]. [Article in French] Bull Cancer. 1999 Oct;86(10):861-5. [http://www.jle.com/en/revues/medecine/bdc/e-docs/00/01/12/15/resume.phtml link to original article & English summary] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/10572237 PubMed]
 [[Category:Chemotherapy regimens]]
 [[Category:Solid oncology regimens]]
 [[Category:Gastrointestinal (GI) oncology regimens]]

Difference between revisions of "Anal cancer"