In patients with localized anal cancer who are older or otherwise unlikely to tolerate standard mitomycin-based chemoradiotherapy, treatment selection requires careful individualisation. The optimal approach in this population remains an active area of clinical consideration.
Localized anal cancer presenting in older patients, or in those who are unlikely to tolerate mitomycin. In this sub-population, the optimal chemotherapy regimen is uncertain and must be tailored to the individual patient's capacity.
Concurrent chemoradiotherapy is a key strategy in this setting, with specific platinum-based and fluoropyrimidine combinations used by experienced clinicians. For patients who cannot tolerate concurrent chemotherapy, radiotherapy-based options may also be considered.
Full regimen details, decision criteria, and sequencing are available in the complete structured protocol.
DOI: 10.6004/jnccn.2023.0030
For older patients or those who are unlikely to tolerate mitomycin, the optimal chemotherapy regimen remains uncertain.
Some NCCN Panel members have used a combination of weekly cisplatin and daily 5-FU on days of RT for chemoRT in localized anal cancer.
Other potential strategies for this patient population may include capecitabine + RT or RT alone (without chemotherapy).
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