What are special considerations in the treatment of anal cancer?

Updated: Apr 07, 2020
  • Author: Jeffrey B VanDeusen, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

Answer

See the list below:

  • Consider HIV testing and CD4 count analysis in patients with clinical risk factors.

  • No changes to therapy are indicated in HIV-infected patients; however, consider dose reduction of mitomycin in patients with low CD4 counts and a history of complications such as opportunistic infections or other malignancies. [5]

  • Mitomycin + 5-FU: If nadir WBC count is less than 2400 but more than 1000/μL or if nadir platelet count is more than 50,000 but less than 85,000/μL, the second dose of mitomycin is reduced to 7.5 mg/m2 from 10 mg/m2

  • If nadir WBC count is less than 1000 or if platelet count is less than 50,000/μL, the second dose of mitomycin is reduced to 5 mg/m2 from 10 mg/m2

  • If on day 28 the WBC count is less than 2400/μL or if the platelet count is less than 85,000/μL, delay chemotherapy 1wk [3]


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