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ANUS (W/S (5 yrs after definitive CRT? (OS is ~70% (RTOG 9811), sphincter…

- - - - zašto
        
        određuje se Th
  - - - 70%, 40%
- - - - RTOG 87-04
        
        rez
        
        SS LC, Colostoma FS
        
        nSS OS
        
        MMC/5-FU + RT vs. 5-FU + RT.
        
        290p
  - - - T3--4, N2-3
      - posebno kod abscesa i fistula
    - - cis/5FU pa definitiva KRT
      - CR 80%, OS 70, CoFS 60%
      - faza 2
  - - - 2 studije
        
        RTOG 98-11
        
        640 p
        
        ST - SS CoFS, nSS DFS, LR/DM,
        
        standard therapy vs. 2 cycles of cisplatin/5-FU → cisplatin/5-FU × 2
        with RT.
        
        kritika-indukcijski cis
        
        ACTII
        
        2 × 2 design,
        
        RT+5FU -Mito, Cis////2 ckl 5FU/Cis th održavanja +-
        
        940p
        
        nSS CR, CoFS, PFS, OS
  - - - UKCCCR (ACT I)
        
        p>550
        
        to RT vs. RT + 5-FU/MMC.
        
        rez
        
        ss LR, rizik od smrt
        
        trnd CR
        
        nss OS
      - 550p
        
        to RT vs. RT + 5-FU/MMC.
        
        rez
        
        ss LC, CR
        
        nSS OS
- - - - Wayne state
        
        RT 30Gy/15y + KT 5FU1000 mg/4d +Mito 15 mg/bol
        
        KTRT 71p
        
        FU NED 80%
        
        6w nakon OP-31 p
        
        FU NED 70%
      - PMH
        
        comparing RT alone, 5-FU + RT, or 5-FU/MMC + RT.
        
        Mito/5FU 90 vs RT60% OS
        
        OS 70%
  - - - Švedska- (Goldman
        
        poboljšan OS za KRT
- - - - CTu 3y (T3-4, N+
      - anoskopija, DRE x3mj
      - PD
        
        za mj ponovit
        
        dokaže se ponovo za mj ponovit
        
        biopsija
- - - - higher risk-Adeno LC, DM
    - - gornji vs donji analni kanal
        
        lim drenaža
        
        izbad
        
        POH-I
        
        ispod
        
        obt/ing-externi
    - - djeli
        
        AK od perianalne kože
      - bolja prognoza od AK
    - - 25-35%
      - occult positivity rate for inguinal nodes
        
        10-15%
      - % of clinically palpable LN
        
        50%
    - - extrapelvic visceral mets
        
        5-10%
    - - LC
        
        T, DOI
      - DM
        
        poz LČ
        
        ing, pelvis
- - - - RTOG 0529
      - jednka efekt, manje AE
      - IMRT
        
        RTOG0529
        
        ista LC, manje AE
    - - US ne baš
      - EU-Framcuska
        
        dobra LC-intersticij Ir+EBRT
        
        Papillon
      - slaba LC, osobito uznapredovali>5cm
      - Papillon and
        Montbarbon
        
        EBRT +BT
        
        5yr OS 65%
        
        LC
        
        < tm od 4 cm 80%
        
        4 cm 70%
    - - RT polje
        
        RTOG AP/PA
        
        30Gy L5-S1+LČ
        
        margina 2 do 2.5 cm (prim tumor +LČ)
        
        doza 55 do 60Gy
        
        dno SI od 36 Gy (izbacit -ing LČ)
        
        MDACC
        
        do 30Gy kao RTOG
        
        potom pron pozicija