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Anal Cancer — SCE Medical Oncology MCQ

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ModerateGI CancersAnal CancerSCE Medical Oncology

A 55-year-old woman with locally advanced anal squamous cell carcinoma (T3 N1 M0) is planned for curative treatment. What is the standard definitive treatment?

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Correct answer: C — Concurrent chemoradiotherapy (5-FU + mitomycin C + 50.4 Gy radiotherapy) — the Nigro protocol

The Nigro protocol established concurrent chemoradiotherapy (5-FU + mitomycin C + radiotherapy) as the curative treatment for localised anal SCC, achieving cure in approximately 60-80% with sphincter preservation. This is one of the earliest examples of organ-preserving chemoradiation in oncology. Surgery (APR) is reserved for residual/recurrent disease after CRT. The ACT-II trial confirmed mitomycin C superiority over cisplatin in combination with 5-FU.

Reference: ESMO 2024 Anal Cancer Guidelines; Nigro protocol; ACT-II James et al Lancet Oncol 2013; NICE NG