Niagra protocol for anal cancer

Anal cancers AC are relatively rare tumors. Their incidence is increasing, particularly among men who have sex with other men due to widespread infection by human papilloma virus. The majority of anal cancers are squamous cell carcinomas, and they are treated according to stage. In local and locally advanced AC, concomitant chemoradiation therapy based on mitomycin C and 5-Fluorouracil 5-FU is the current best treatment, while metastatic AC, chemotherapy with 5-FU and cisplatin remains the gold standard.
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Nigro protocol

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Anal cancer treatment: Current status and future perspectives

E-mail address: andy. Nancy Baxter, Surgeon, St. Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. If you have previously obtained access with your personal account, Please log in.
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Anal cancer treatment: Current status and future perspectives

Nigro protocol is the preoperative use of chemotherapy with 5-fluorouracil and mitomycin and medical radiation for squamous cell carcinomas of the anal canal. Larger doses of radiation are used in modern chemoradiotherapy protocols versus the original Nigro protocol radiotherapy dose. In the Nigro protocol, the patient receives 30 Gy rads of radiation over a three week period, as well as continuous administration of fluorouracil for the first four days and on days , with bolus mitomycin on day 1. Response to treatment can be evaluated every weeks for many months if disease is regressing or clinically stable. Any sign of progressive disease should prompt reassessment of disease with biopsy and subsequent surgery with the aforementioned APR.
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In , Dr. Instead, and to their surprise, Dr. Nigro and his colleagues observed complete tumor regression in some patients using this therapy protocol. Their observations suggested that it might be possible to cure anal carcinoma without surgery and its associated after effects.
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