title: Shifting paradigm in the management of anal canal carcinoma.
abstract: BACKGROUND
  Anal canal is the lower most part of the gastrointestinal tract harbouring 4 % of all gastrointestinal cancer. Most common treatment for anal canal carcinoma includes chemoradiotherapy.
  
  
  METHODS
  We reviewed the recent landmark trials to find a road map in the management of anal canal carcinoma.
  
  
  RESULTS
  Concurrent chemoradiotherapy appears to be the most effective treatment schedule. Induction, as well as maintenance chemotherapy, has no definite role. Moderate dose radiation 50.4-54 Gy with concurrent mitomycin C (MMC) and 5-fluorouracil (5-FU) remains the standard. Split course is detrimental. Intensity-modulated radiotherapy and targeted drugs are investigated.
  
  
  CONCLUSIONS
  Combined modality therapy is the standard for anal canal carcinoma.
authors.affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India, drsupriyamallick@gmail.com.
authors.forename: Supriya
authors.initials: S
authors.lastname: Mallick
authors.forename: Rony
authors.initials: R
authors.lastname: Benson
authors.forename: P K
authors.initials: PK
authors.lastname: Julka
authors.forename: G K
authors.initials: GK
authors.lastname: Rath
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001005:Anus Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D059248:Chemoradiotherapy; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome