Peiffert D
Département de radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, CS 30519, 54500 Vandœuvre-lès-Nancy, France.
Cancer Radiother. 2015 Oct;19(6-7):416-20. doi: 10.1016/j.canrad.2015.06.005. Epub 2015 Sep 1.
Anal canal carcinomas remain rare, but their management has improved recently. The PET-CT is now used as a standard at the first diagnosis and after relapses. The introduction of intensity-modulated irradiation techniques makes it possible to better conform the pelviperineal and inguinal volumes, improving the homogeneity of the irradiation while sparing some pelvic structures, thus reducing acute and late effects. Nevertheless, the conversion from 3D to intensity-modulated radiotherapy needs a specific and careful approach, mainly for the management of the perineal region, where relapses and complications occur. Last but not least, new chemotherapy associations are studied for metastatic disease.
肛管癌仍然少见,但近年来其治疗方法有所改进。目前,正电子发射断层扫描-计算机断层扫描(PET-CT)在首次诊断及复发后被用作标准检查。调强放疗技术的引入使得更好地适形盆腔会阴和腹股沟区域成为可能,在减少一些盆腔结构受照射剂量的同时提高了照射的均匀性,从而降低急性和晚期效应。然而,从三维放疗转换为调强放疗需要一种特定且谨慎的方法,主要是针对会阴区域的处理,因为该区域会出现复发和并发症。最后同样重要的是,正在研究针对转移性疾病的新化疗联合方案。