Anal Carcinoma, Version 2.2012: featured updates to the NCCN guidelines

Area of Science:

• Oncology
• Radiation Oncology
• Medical Guidelines

Background:

• Squamous cell anal carcinoma is the most common type of anal cancer.
• The National Comprehensive Cancer Network (NCCN) provides guidelines for cancer treatment.
• The 2012 NCCN Guidelines for Anal Carcinoma underwent revisions based on panel discussions.

Purpose of the Study:

• To summarize key changes in the 2012 NCCN Guidelines for Anal Carcinoma.
• To highlight updates in the management and workup of squamous cell anal carcinoma.
• To inform clinicians about revised recommendations for radiation therapy and imaging.

Main Methods:

• Review of major discussion points from the 2012 NCCN Anal Carcinoma Panel meeting.
• Analysis of proposed and implemented changes to the NCCN Guidelines.
• Inclusion of risk reduction strategies in the guideline discussion.

Main Results:

• Local radiation therapy is now an option for metastatic anal carcinoma.
• Multifield technique is the preferred radiation delivery method over anteroposterior-posteroanterior (AP-PA) technique.
• Positron Emission Tomography/Computed Tomography (PET/CT) is recommended for radiation therapy planning and considered for anal canal cancer workup.

Conclusions:

• The NCCN Guidelines for Anal Carcinoma have been updated with significant changes in treatment and planning.
• Radiation therapy recommendations have evolved, particularly for metastatic disease and technique selection.
• The role of PET/CT in the workup and planning for anal carcinoma has been clarified.