MRI for Tumor During Chemoradiation for Anal Canal and Perianal Cancer
MRI for Tumor During Chemoradiation for Anal Canal and Perianal Cancer
The purpose of this study is to establish a prospective database of anal canal and perianal
 cancer patients treated with IMRT and chemotherapy with curative intent at PMH for the
 purposes of investigating MRI-derived primary tumor parameters. Patients who decide to
 participate in this study will be treated according to standard treatment policies and
 radiation therapy planning protocols at Princess Margaret Hospital (PMH) with radiation
 therapy +/- chemotherapy. IMRT for all treatment phases of radiotherapy has been implemented
 as standard treatment. Surgery is reserved for salvage treatment.
Anal cancer is an uncommon cancer, accounting for 2% of gastrointestinal cancers. Prognostic
 factors include tumor differentiation and staging, along with patient gender, race, and
 socioeconomic status. The standard of care is radical chemoradiation with 5-fluorouracil and
 mitomycin C, with surgery reserved for salvage. Intensity modulated radiation therapy (IMRT)
 is a specialized radiotherapy technique that may be used for anal cancer. IMRT allows the
 radiation dose to conform to the three-dimensional shape of the target volume more than
 conventional two-dimensional techniques, and it may reduce treatment toxicities without
 compromising tumor control. At the Princess Margaret Hospital (PMH) since July 2007, IMRT for
 all treatment phases of radiotherapy has been implemented as standard treatment for patients
 with anal canal and perianal cancer.
Inclusion Criteria:

 -  histological confirmation of invasive primary squamous cell carcinoma or
 adenocarcinoma of the anal canal or perianal region

 -  treatment with curative intent

 -  patients who are not eligible for chemotherapy and receive IMRT alone are eligible for
 evaluation

 -  primary anal or perianal cancer evaluable on cross-sectional imaging (CT or MRI) scan

 -  ECOG performance status of 0, 1, or 2

 -  age > 18 years

 -  able to provide informed consent

 Exclusion Criteria:

 -  evidence of distant metastasis (M1)

 -  prior radiation therapy to the pelvis or contraindication to radiotherapy

 -  contraindication to MRI imaging

 -  known allergy to intravenous Gadolinium

 -  renal insufficiency (serum creatinine greater than 150)

 -  serious claustrophobia

 -  cardiac pacemaker

 -  hip prosthesis

 -  major medical or psychiatric illness which, in the investigator's opinion, would
 prevent completion of imaging study