title: Feasibility of image-guided radiotherapy based on tomotherapy for the treatment of locally advanced anal carcinoma.
abstract: BACKGROUND
  The standard of care for locally advanced anal cancer has been concurrent chemoradiation. However, conventional treatment with 3-dimensional radiotherapy is associated with significant toxicity. The feasibility of new radiotherapy techniques such as image-guided radiotherapy (IGRT) in combination with chemotherapy for the treatment of this malignancy was assessed.
  
  
  METHODS
  A retrospective review of five patients with locally advanced anal carcinoma treated with Tomotherapy-based IGRT was conducted. All the patients received concurrent chemotherapy.
  
  
  RESULTS
  Gastrointestinal toxicity remained the limiting factor as four patients experienced grade 3-4 enteritis requiring a break during treatment. No patient experienced grade 3-4 hematological toxicity. Despite the large tumor size, three patients achieved local control at a median follow-up of 19 months.
  
  
  CONCLUSIONS
  Tomotherapy-based IGRT may be a promising treatment for locally advanced anal cancer and needs to be investigated in further prospective trials.
authors.affiliation: Department of Radiation Oncology, University of Arizona, 1501 N. Campbell Ave, Tucson, AZ 85724-5081, USA. NamPhong.Nguyen@yahoo.com
authors.forename: Nam P
authors.initials: NP
authors.lastname: Nguyen
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Vock
authors.forename: Thomas
authors.initials: T
authors.lastname: Sroka
authors.forename: Rihan
authors.initials: R
authors.lastname: Khan
authors.forename: Siyoung
authors.initials: S
authors.lastname: Jang
authors.forename: Alexander
authors.initials: A
authors.lastname: Chi
authors.forename: Michael
authors.initials: M
authors.lastname: Betz
authors.forename: Lars
authors.initials: L
authors.lastname: Ewell
authors.forename: Deirdre
authors.initials: D
authors.lastname: Cohen
authors.forename: Richard P
authors.initials: RP
authors.lastname: Vo
authors.forename: Melissa
authors.initials: M
authors.lastname: Mills
authors.forename: Vincent
authors.initials: V
authors.lastname: Vinh-Hung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D002277:Carcinoma / Q000473:pathology / Q000532:radiotherapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome