Adaptive Radiation in Anal Cancer

Inclusion Criteria

• •Histologically proven, invasive primary squamous, basaloid or cloacogenic carcinoma of the anal canal.
• •American Joint Committee on Cancer (AJCC) 8th edition stage T2 \> 4 cm, T3-4 or N1.
• •Age ≥18 years.
• •Eastern Cooperative Oncology Group (ECOG) performance status ≤2 (Karnofsky ≥60%).
• •Life expectancy of greater than 12 months.
• •Patients must have normal organ and marrow function as defined below:
• •leukocytes greater than or equal to 3,000/microliter
• •absolute neutrophil count greater than or equal to 1,500/microliter
• •platelets greater than or equal to 100,000/microliter
• •total bilirubin within normal institutional limits
• •Aspartate transaminase (AST)(SGOT)/Alanine transaminase (ALT)(SGPT) ≤ 2.5 × institutional upper limit of normal
• •creatinine within normal institutional limits OR creatinine clearance ≥60 mL/min/1.73 m2 for patients with creatinine levels above institutional normal.
• •Females of childbearing potential and males must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 6 months after completion of study therapy. All pregnancies must be reported.
• •Ability to understand and the willingness to sign a written informed consent document.