Difference between revisions of "Anal cancer"
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Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are [[How_to_contribute|invited to contribute to the site]]. | Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are [[How_to_contribute|invited to contribute to the site]]. | ||
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=Chemotherapy & radiation therapy= | =Chemotherapy & radiation therapy= | ||
==Fluorouracil, cisplatin, radiation therapy {{#subobject:1 |Regimen=1}}== | ==Fluorouracil, cisplatin, radiation therapy {{#subobject:1 |Regimen=1}}== | ||
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===Regimen {{#subobject:1 |Variant=1}}=== | ===Regimen {{#subobject:1 |Variant=1}}=== | ||
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==Fluorouracil, mitomycin, radiation therapy {{#subobject:2 |Regimen=1}}== | ==Fluorouracil, mitomycin, radiation therapy {{#subobject:2 |Regimen=1}}== | ||
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===Regimen #1, James et al. 2013 (ACT II) {{#subobject:2 |Variant=1}}=== | ===Regimen #1, James et al. 2013 (ACT II) {{#subobject:2 |Variant=1}}=== | ||
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==Radiation therapy {{#subobject:3 |Regimen=1}}== | ==Radiation therapy {{#subobject:3 |Regimen=1}}== | ||
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===Regimen {{#subobject:5 |Variant=1}}=== | ===Regimen {{#subobject:5 |Variant=1}}=== | ||
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=Chemotherapy= | =Chemotherapy= | ||
==Fluorouracil & Cisplatin {{#subobject:4 |Regimen=1}}== | ==Fluorouracil & Cisplatin {{#subobject:4 |Regimen=1}}== | ||
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===Regimen, Faivre et al. 1999 {{#subobject:6 |Variant=1}}=== | ===Regimen, Faivre et al. 1999 {{#subobject:6 |Variant=1}}=== | ||
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Revision as of 06:58, 8 February 2015
Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer.
Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are invited to contribute to the site.
9 regimens on this page
13 variants on this page
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Chemotherapy & radiation therapy
Fluorouracil, cisplatin, radiation therapy
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Regimen
Level of Evidence: Phase III
Inferior to fluorouracil/mitomycin/radiation therapy; included for reference purposes only.
References
- 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. link to original article contains verified protocol 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. doi: 10.1016/S1470-2045(13)70086-X. Epub 2013 Apr 9. link to original article contains verified protocol PubMed
Fluorouracil, mitomycin, radiation therapy
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Regimen #1, James et al. 2013 (ACT II)
Level of Evidence: Phase III
- Fluorouracil (5-FU) 1000 mg/m2/day IV continuous infusion on days 1 to 4, 29 to 32
- Mitomycin (Mutamycin) 12 mg/m2 (maximum dose per cycle: 20 mg) IV bolus once on day 1
- Concurrent radiation therapy in James et al. 2013: 1.8 Gy per day x 28 fractions (total dose: 50.4 Gy), given over 5.5 weeks; see James et al. 2013 for details
5.5-week course
Regimen #2, UKCCCR Anal Cancer Trial Working Party 1996 (ACT I) & Northover et al. 2010 (ACT I)
Level of Evidence: Phase III
Because there were a few different schedules used in UKCCCR Anal Cancer Trial Working Party 1996 and Northover et al. 2010, there is some variability in potential schedules.
- Fluorouracil (5-FU) 1000 mg/m2/day IV continuous infusion over 4 days (total dose for the week's treatment: 4000 mg/m2) 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/m2/day IV continuous infusion over 5 days (total dose for the week's treatment: 3750 mg/m2) during the first and last weeks of radiation therapy
- Mitomycin (Mutamycin) 12 mg/m2 (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, Ajani et al. 2008 (RTOG 98-11)
Level of Evidence: Phase III
- Fluorouracil (5-FU) 1000 mg/m2/day IV continuous infusion on days 1 to 4, 29 to 32
- Mitomycin (Mutamycin) 10 mg/m2 (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 Ajani et al. 2008 for additional details
5-week course
Supportive medications:
- "Patients received appropriate premedications and hydration."
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. link to original article contains verified protocol 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. doi: 10.1038/sj.bjc.6605605. Epub 2010 Mar 16. link to original article contains verified protocol PubMed
- 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. link to original article contains verified protocol 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. doi: 10.1016/S1470-2045(13)70086-X. Epub 2013 Apr 9. link to original article contains verified protocol PubMed
Radiation therapy
| back to top |
Regimen
Level of Evidence: Phase III
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. link to original article contains verified protocol 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. doi: 10.1038/sj.bjc.6605605. Epub 2010 Mar 16. link to original article contains verified protocol PubMed
Chemotherapy
Fluorouracil & Cisplatin
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Regimen, Faivre et al. 1999
Level of Evidence: Pilot, <20 patients reported
- Fluorouracil (5-FU) 1000 mg/m2/day IV continuous infusion on days 1 to 5
- Cisplatin (Platinol) 100 mg/m2 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. link to original article & English summary contains protocol PubMed