Utilization of intensity modulated radiation therapy for anal cancer in the United States

Combined chemoradiotherapy (CRT) for anal cancer (AC) is an efficacious measure which provides high rates of disease control and survival; it is thus the consensus paradigm to treat most cases of AC (1). However, concurrent CRT can also incur high rates of treatment-related toxicities, including perianal symptoms, which can be severely debilitating and substantially impair tolerance of full-dose CRT as well as quality of life. To this extent, radiation therapy (RT) has markedly advanced from the historical use of two- or three-dimensional conformal RT (2D/3DCRT) to inverse-planned intensity-modulated RT (IMRT), which creates highly conformal dose distributions and minimizes toxicities to several organs-at-risk (OARs)