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RPCI Uses "Dose-painted" Radiation Therapy to Improve Quality of Life for Anal Cancer Patients.

Most patients with anal cancer receive radiation as part of their treatment plan, but the anus is “a very sensitive area of the human body, almost like the fingertips,” notes Gary Yang, MD, Director of Gastrointestinal Radiation Medicine at Roswell Park Cancer Institute (RPCI).

That’s of special concern, because radiation can burn the skin and cause other side effects that can bring treatments to a halt. “And if the patient has to take a break during treatment, you’re giving the tumor a break, too,” says Dr. Yang, who also serves on the National Comprehensive Cancer Network (NCCN) Esophageal/Gastric Cancers Guidelines Committees.

RPCI is among only a handful of centers in North America that use “dose-painted” intensity-modulated radiation therapy (IMRT) to precisely target anal tumors with high-dose radiation while minimizing the exposure of healthy tissue in the small bowel, bladder, external genitalia, skin and bone marrow.

“We can spare the anal sphincter so a patient doesn’t have to have a colostomy bag,” he adds. “With a combination of chemotherapy and dose-painted IMRT, 75% of patients should be able to avoid lifelong colostomy resulting from anal surgery. There’s better quality of life, and a better outcome, because there are no interruptions to treatment.”

While IMRT is used widely for treating other cancer sites, “it has not been implemented for anal cancer [at most institutions], due to the level of technology and support it requires,” says Dr. Yang. “You can have a top-of-the-line machine, but you also need highly experienced cancer specialists, dosimetrists, physicists and support staff working together to determine the best treatment plan.”

Source: Roswell Park Cancer Institute

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