Miller Eric, Bazan Jose
Department of Radiation Oncology at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA.
Cancers (Basel). 2021 Apr 27;13(9):2099. doi: 10.3390/cancers13092099.
The incidence of squamous cell carcinoma of the anus (SCCA) is increasing, particularly in the elderly, with increased mortality in this age group. While the current standard of care for localized SCCA remains chemoradiation (CRT), completion of this treatment can be challenging with risks for severe acute and late toxicity. It remains unclear if full course CRT is required for the management of early-stage SCCA or if de-escalation of treatment is possible without compromising patient outcomes. Alternative therapies include radiation therapy alone or local excision for appropriate patients. Modifying standard CRT may also reduce toxicity including the routine use of intensity-modulated radiation therapy for treatment delivery, modification of treatment volumes, and selection and dosing of concurrent systemic therapy agents. Finally, we provide an overview of currently accruing prospective trials focused on defining the role of de-escalation of therapy in patients with early-stage SCCA.
肛门鳞状细胞癌（SCCA）的发病率正在上升，尤其是在老年人中，该年龄组的死亡率也在增加。虽然目前局部SCCA的标准治疗方法仍然是放化疗（CRT），但完成这种治疗可能具有挑战性，存在严重急性和晚期毒性的风险。对于早期SCCA的管理，是否需要全程CRT，或者在不影响患者预后的情况下是否可以降低治疗强度，目前尚不清楚。替代疗法包括单独放疗或对合适的患者进行局部切除。调整标准CRT也可能降低毒性，包括在治疗实施中常规使用调强放疗、调整治疗体积以及选择和确定同期全身治疗药物的剂量。最后，我们概述了目前正在进行的前瞻性试验，这些试验专注于确定在早期SCCA患者中降低治疗强度的作用。
