Anal Cancer

Question 1

Localized disease

Answer 1

5-FU + Mitomycin + RT
• Continuous infusion 5-FU 1000 mg/m2/d IV days 1–4 and 29-32
+ Mitomycin 10 mg/m2 IV bolus days 1 and 29
+ Concurrent radiotherapy
or
• Continuous infusion 5-FU 1000 mg/m2/d IV days 1–4 and 29–32
+ Mitomycin 12 mg/m2 on day 1 (capped at 20 mg) + Concurrent radiotherapy

Capecitabine + Mitomycin + RT 
• Capecitabine 825 mg/m2 PO BID, Monday–Friday,  on each day that RT is given, throughout the duration of RT (typically 28 treatment days) 
\+ Mitomycin 10 mg/m2 days 1 and 29 
\+ Concurrent radiotherapy
or 
• Capecitabine 825 mg/m2 PO BID days 1–5 weekly x 6 weeks 
\+ Mitomycin 12 mg/m2 IV bolus day 1 
\+ Concurrent radiotherapy

5-FU + Cisplatin
Continuous infusion 5-FU 1000 mg/m2/d IV days 1–5
+ Cisplatin 100 mg/m2 IV day 2 Repeat every 4 weeks
+ Concurrent radiotherapy

Question 2

Metastatic disease

Answer 2

5-FU + Cisplatin
Continuous infusion 5-FU 1000 mg/m2/d IV days 1–5
+ Cisplatin 100 mg/m2 IV day 2
(Repeat every 4 weeks)