Skip to main content Accessibility help
Hostname: page-component-8bbf57454-nshs2 Total loading time: 0.374 Render date: 2022-01-25T06:01:29.702Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Book contents

17 - Management of cancer of the anus

Published online by Cambridge University Press:  05 November 2015

Richard Adams
Velindre Cancer Centre, Velindre Hospital, Cardiff, UK
Paul Shaw
Cardiff University, Cardiff, UK
Louise Hanna
Velindre Cancer Centre, Velindre Hospital, Cardiff
Tom Crosby
Velindre Cancer Centre, Velindre Hospital, Cardiff
Fergus Macbeth
Velindre Cancer Centre, Velindre Hospital, Cardiff
Get access


Image of the first page of this content. For PDF version, please use the ‘Save PDF’ preceeding this image.'
Publisher: Cambridge University Press
Print publication year: 2015

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Anal Cancer Trial Working Party. (1996). Epidermoid anal cancer: results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5-fluorouracil and mitomycin. Lancet, 348, 1049–1054.
Andreyev, H. J., Benton, B., Lalji, A., et al. (2013). Algorithm-based management of patients with gastrointestinal symptoms in patients after pelvic radiation treatment (ORBIT): a randomised controlled trial. Lancet, 382, 2084–2092.CrossRefGoogle ScholarPubMed
Bartelink, H., Roelofsen, F., Eschwege, F., et al. (1997). Concomitant radiotherapy and chemotherapy is superior to radiotherapy alone in the treatment of locally advanced anal cancer: results of a phase III randomized trial of the European Organization for Research and Treatment of Cancer Radiotherapy and Gastrointestinal Cooperative Groups. J. Clin. Oncol., 15, 2040–2049.Google ScholarPubMed
Charnley, N., Choudhury, A., Chesser, P., et al. (2005). Effective treatment of anal cancer in the elderly with low-dose chemoradiotherapy. Br. J. Cancer, 92, 1221–1225.CrossRefGoogle ScholarPubMed
Cummings, B., Keane, T., Thomas, G., et al. (1984). Results and toxicity of the treatment of anal canal carcinoma by radiation therapy or radiation therapy and chemotherapy. Cancer, 54, 2062–2068.3.0.CO;2-T>CrossRefGoogle ScholarPubMed
Daling, J. R., Weiss, N. S., Klopfenstein, L. L., et al. (1982). Correlates of homosexual behavior and the incidence of anal cancer. J. Am. Med. Assoc., 247, 1988–1990.CrossRefGoogle ScholarPubMed
Daling, J. R., Weiss, N. S., Hislop, T. G., et al. (1987). Sexual practices, sexually transmitted diseases and the incidence of anal cancer. N. Engl. J. Med., 317, 973–977.CrossRefGoogle ScholarPubMed
Flam, M., John, M., Pajak, T. F., et al. (1996). Role of mitomycin in combination with fluorouracil and radiotherapy, and of salvage chemoradiation in the definitive nonsurgical treatment of epidermoid carcinoma of the anal canal: results of a phase III randomized intergroup study. J. Clin. Oncol., 14, 2527–2539.CrossRefGoogle ScholarPubMed
Fuccio, L., Guido, A. and Andreyev, H. J. (2012). Management of intestinal complications in patients with pelvic radiation disease. Clin. Gastroenterol. Hepatol., 10, 1326–1334.CrossRefGoogle ScholarPubMed
Gilbert, D. C., Williams, A., Allan, K., et al. (2013). p16INK4A, p53, EGFR expression and KRAS mutation status in squamous cell cancers of the anus: correlation with outcomes following chemo-radiotherapy. Radiother. Oncol., 109, 146–151.CrossRefGoogle ScholarPubMed
Glynne-Jones, R., Meadows, H., Wan, S., et al. (2008). EXTRA – a multicenter phase II study of chemoradiation using a 5 day per week oral regimen of capecitabine and intravenous mitomycin C in anal cancer. Int. J. Radiat. Oncol. Biol. Phys., 72, 119–126.CrossRefGoogle Scholar
Glynne-Jones, R., Sebag-Montefiore, D., Adams, R., et al. (2011). ‘Mind the gap’ – the impact of variations in the duration of the treatment gap and overall treatment time in the first UK Anal Cancer Trial (ACT I). Int. J. Radiat. Oncol. Biol. Phys., 81, 1488–1494.CrossRefGoogle Scholar
Gunderson, L. L.Winter, K. A., Ajani, J. A., et al. (2012). Long-term update of US GI Intergroup RTOG 98-11 phase III trial for anal carcinoma: survival, relapse, colostomy failure with concurrent chemoradiation involving fluorouracil/mitomycin versus fluorouracil/cisplatin. J. Clin. Oncol., 30, 4344–4351.CrossRefGoogle ScholarPubMed
Hu, K., Minsky, B. D., Cohen, A. M., et al. (1999). 30 Gy may be an adequate dose in patients with anal cancer treated with excisional biopsy followed by combined modality therapy. J. Surg. Oncol., 70, 71–77.3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
James, R. D., Glynne-Jones, R., Meadows, H. M., et al. (2013). Mitomycin or cisplatin chemoradiation with or without maintenance chemotherapy for treatment of squamous-cell carcinoma of the anus (ACT II): a randomised, phase 3, open-label, 2 x 2 factorial trial. Lancet Oncol., 14, 516–524.CrossRefGoogle ScholarPubMed
Matthews, J. H., Burmeister, B. H., Borg, M., et al. (2011). T1–2 anal carcinoma requires elective inguinal radiation treatment – the results of Trans Tasman Radiation Oncology Group study TROG 99.02. Radiat. Oncol., 98, 93–98.Google ScholarPubMed
Ng, M., Leong, T., Chander, S., et al. (2012). Australasian Gastrointestinal Trials Group (AGITG) contouring atlas and planning guidelines for intensity-modulated radiotherapy in anal cancer. Int. J. Radiat. Oncol. Biol. Phys., 83, 1455–1462.CrossRefGoogle ScholarPubMed
NICE. (2004). Guidance on Cancer Services. Improving Outcomes in Colorectal Cancers. Manual Update. London: National Institute for Health and Care Excellence.
Nigro, N. D., Vaitkevicius, V. K. and Considine, B., Jr. (1974). Combined therapy for cancer of the anal canal: a preliminary report. Dis. Colon Rectum, 17, 354–356.CrossRefGoogle ScholarPubMed
Nigro, N. D., Seydel, H. G., Considine, B., et al. (1983). Combined preoperative radiation and chemotherapy for squamous cell carcinoma of the anal canal. Cancer, 51, 1826–1829.3.0.CO;2-L>CrossRefGoogle ScholarPubMed
Peiffert, D., Tournier-Rangeard, L., Gérard, J. P., et al. (2012). Induction chemotherapy and dose intensification of the radiation boost in locally advanced anal canal carcinoma: final analysis of the randomized UNICANCER ACCORD 03 trial. J. Clin. Oncol., 30, 1941–1948.CrossRefGoogle ScholarPubMed
Renehan, A. G., Saunders, M. P., Schofield, P. F., et al. (2005). Patterns of local disease failure and outcome after salvage surgery in patients with anal cancer. Br. J. Surg., 92, 605–614.CrossRefGoogle ScholarPubMed
Royal College of Radiologists. (2008). The Timely Delivery of Radical Radiotherapy: Standards and Guidelines for the Management of Unscheduled Treatment Interruptions, Third Edition, 2008.London: Royal College of Radiologists.
Saboo, S. S., Zukotynski, K., Shinagare, A. B., et al. (2013). Anal carcinoma: FDG PET/CT in staging, response evaluation, and follow-up. Abdom. Imaging, 38, 728–735.CrossRefGoogle ScholarPubMed
Tilston, P. (1997). Anal human papilloma virus and anal cancer. J. Clin. Pathol., 50, 625–634.CrossRefGoogle ScholarPubMed
UICC. (2009). TNM Classification of Malignant Tumours, ed. Sobin, L. H., Gospodarowicz, M and Wittekind, Ch., 7th edn. Chichester: Wiley-Blackwell, pp. 106–109.
Weber, D. C., Kurtz, J. M. and Allal, A. S. (2001). The impact of gap duration on local control in anal canal carcionma treated by split-course radiotherapy and concomitant chemotherapy. Int. J. Radiat. Oncol. Biol. Phys., 50, 675–680.CrossRefGoogle Scholar
Wiesendanger-Wittmer, E. M., Sijtsema, N. M., Muijs, C. T., et al. (2012). Systematic review of the role of a belly board device in radiotherapy delivery in patients with pelvic malignancies. Radiother. Oncol., 102, 325–334.CrossRefGoogle ScholarPubMed

Send book to Kindle

To send this book to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats

Send book to Dropbox

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox.

Available formats

Send book to Google Drive

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive.

Available formats