Bone-sparing Chemoradiotherapy for Anal Cancer - DACG-II

Bone-sparing Chemoradiotherapy for Anal Cancer - A Prospective Phase II Trial Danish Anal Cancer Group Study

This study proposal includes a prospective clinical trial of bone sparing treatment planning in anal cancer patients. the trial aim to lower the risk of bone damage, while adhering with the constrains to the bowel, bladder and other conventional Organs At Risk, and finally to describe the fraction of pelvic insufficiency fractures in patients treated with optimized radiotherapy.

Patients will receive standard (chemo)-radiotherapy according to national Danish Anal Cancer Group (DACG) guidelines, but the bone-sparing focus will be added to the algorithm for dose-constrains and planning objectives. A bone specific magnetic resonance scan will be performed at 1 year post treatment. Additional substudies include collection of blood samples for translational research purposes.

Inclusion Criteria:

• Patients with biopsy verified localized squamous cell anal cancer
• Indication for standard (chemo)-radiotherapy with curative intend for anal cancer as per multidisciplinary team decision
• Clinical eligible for standard (chemo)-radiotherapy as per physicians' decision
• Written and oral consent
• Age at least 18 years

Exclusion Criteria:

• Previous pelvic radiotherapy
• Previous systemic therapy with severe bone marrow suppression or hematological diseases
• Hip-replacements
• Contraindications to MRI-scan