Back to sessions
Sep 27
Education

EDU 06 - Radiotherapy Treatment Planning for Anal Cancer: Personalized Radiation and Modern Techniques

05:00pm - 06:00pm ET
Gastrointestinal Cancer

MODERATOR(S)

Joshua Meyer, MD, FASTRO - Fox Chase Cancer Center

session DESCRIPTION

While chemoradiation for localized anal cancer is the standard of care, and locoregional control remains critical for cure, radiation treatment is complex and technically challenging. RTOG 0529 evaluated IMRT treatment in anal cancer, demonstrating reduced toxicity. RT QA analysis revealed 81% of plans required replanning. Recent U.S./UK trials explore radiation dose and target volume optimization for early-stage disease (EA 2182/DECREASE and PLATO-ACT 4), with results from ACT 4 showing encouraging rates of clinical complete response and few local-regional failures. Pre-treatment RT plan review on DECREASE demonstrates high non-compliance (data in submission for ASTRO 2026), mainly due to contouring deviations. A majority of the non-compliant plans are due to deviations from standard-of-care contours. ACT5 investigated RT dose escalation in locally advanced disease, which can be challenging due to bowel dose limits. This session addresses knowledge gaps in modern RT for anal cancer, including IMRT, IGRT, nodal patterns, recurrence patterns, contouring guidelines, differences from rectal cancer, and immobilization/simulation including vaginal dilators.

learning objectives

  1. Contour anal cancer patients by stage appropriately to maximize outcomes and minimize toxicity.
  2. Increase confidence with pelvic anatomy and available contouring resources.
  3. Discuss with patients genital-sparing techniques (vaginal dilator).

Credits

AMA PRA Category 1 Credits: 1.00

Rate This Session

Presentations