Would you ever recommend radiation alone for a T1N0 anal cancer?

The standard of care for almost all anal cancers (even small node negative tumors) is concurrent chemoradiation, as it is associated with a better colostomy free survival and disease free survival compared to treatment with RT alone. There is a retrospective study showing a 2 fold increase in loco-regional failure in patients with early stage tumors being treated with radiation alone. With a disease that is highly curable with combined modality treatment with lower doses of RT (~45 Gy based on R...