Clinical Condition: Anal Cancer

Variant 1: 45-year-old patient, T3N0M0. Karnofsky performance score (KPS) 80

Treatment	Rating	Comments
RT + 5-FU + MMC	9	For CDDP, see text.
RT alone	2
RT + 5-FU	2
External beam + brachytherapy	2
APR	1
If RT + Chemotherapy: RT Dose to Primary
40 Gy/2.0 Gy	2
45 Gy/1.8 Gy	3
50.4 Gy/1.8 Gy	5
54 Gy/1.8 Gy	8
59.4 Gy/1.8 Gy	8
Technique: RT
IMRT	8
AP/PA photons	8
PA + laterals + electron boost to inguinal LNs	8
4-field box	3
If RT + Chemotherapy: RT Volume Needed
Pelvis + primary + medial inguinal LNs	8
Pelvis + primary + lateral inguinal LNs	7
Primary alone	1
Routine Post-treatment Biopsy
If progressive disease observed	9
If clinical regression observed	1
If stable disease observed	1
Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate