What dose do you use for T2 anal squamous cell carcinomas measuring greater than 3cm?

These dose questions are very difficult to answer. 50.4Gy and 54Gy are both acceptable answers to this question. Most academic centers use their own data to justify the doses that they use. To give you an example, when I started my career at MD Anderson in the 3-D era, every patient got 55Gy. When we analyzed the data we found that the local control was excellent for Tx -T2 but we had local control limitations for T3 and T4 (25% or so). Naturally, we wanted to address that and gave a higher boos...

I have on one occasion, for a patient with a well-lateralized 4.5 cm anal carcinoma (with a 4 cm involved contralateral internal iliac node with marked PET/CT FDG avidity and biopsy-proven) started treatment by inserting an "anal obturator" (a 10 cc syringe filled with wax) and used an IGRT-IMRT technique (sort of an SBRT) to give 200 cGy x3 to the involved side of the anal canal while giving only 100 cGy x3 to the uninvolved side, then using an SIB technique to give an additional 5040 cGy to th...