Radiotherapy dose and target volume prescriptions for anal squamous cell carcinoma (ASCC) vary considerably in daily practice and guidelines, including those from NCCN, UK, Australasian, and ESMO. We conducted a pattern-of-care survey to assess the patient management in German speaking countries. We developed an anonymous questionnaire comprising 18 questions on diagnosis and treatment of ASCC. The survey was sent to 361 DEGRO-associated institutions, including 41 university hospitals, 118 non-university institutions, and 202 private practices. We received a total of 101 (28%) surveys, including 20 (19.8%) from university, 36 (35.6%) from non-university clinics, and 45 (44.6%) from private practices. A total of 28 (27.8%) institutions reported to treat more than 5 patients with early-stage ASCC and 42 (41.6%) institutions treat more than 5 patients with locoregionally-advanced ASCC per year. Biopsy of suspicious inguinal nodes was advocated in only 12 (11.8%) centers. Screening for human immunodeficiency virus (HIV) is done in 28 (27.7%). Intensity modulated radiotherapy or similar techniques are used in 97%. The elective lymph node dose ranged from 30.6 Gy to 52.8 Gy, whereas 87% prescribed 50.4–55. 8 Gy (range: 30.6 to 59.4 Gy) to the involved lymph nodes. The dose to gross disease of cT1 or cT2 ASCC ranged from 50 to ≥60 Gy. For cT3 or cT4 tumors the target dose ranged from 54 Gy to more than 60 Gy, with 76 (75.2%) institutions prescribing 59.4 Gy. The preferred concurrent chemotherapy regimen was 5-FU/Mitomycin C, whereas 6 (6%) prescribed Capecitabine/Mitomycin C. HIV-positive patients are treated with full-dose CRT in 87 (86.1%) institutions. First assessment for clinical response is reported to be performed at 4–6 weeks after completion of CRT in 2 (2%) institutions, at 6–8 weeks in 20 (19.8%), and 79 (78%) institutions wait up to 5 months. We observed marked differences in radiotherapy doses and treatment technique in patients with ASCC, and also variable approaches for patients with HIV. These data underline the need for an consensus treatment guideline for ASCC.

中文翻译：

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肛门癌患者的管理-德语国家的护理分析模式。

肛门鳞状细胞癌（ASCC）的放射治疗剂量和目标剂量处方在日常实践和指南中有很大差异，包括来自NCCN，英国，澳大利亚和ESMO的那些。我们进行了护理模式调查，以评估德语国家的患者管理情况。我们开发了一个匿名问卷，包括关于ASCC的诊断和治疗的18个问题。该调查已发送给361家与DEGRO相关的机构，包括41家大学医院，118家非大学机构和202家私人诊所。我们总共接受了101次（28％）的调查，包括来自大学的20项（19.8％），来自非大学诊所的36项（35.6％）以及来自私人诊所的45项（44.6％）。共有28家（27.8％）机构报告要治疗5例以上早期ASCC患者和42例（41。6％）的机构每年治疗5例局部区域先进的ASCC患者。仅在12个（11.8％）中心主张对可疑腹股沟淋巴结活检。在28（27.7％）人中进行了人类免疫缺陷病毒（HIV）的筛选。97％使用了调强放射疗法或类似技术。选择性淋巴结的剂量范围为30.6 Gy至52.8 Gy，而87％的处方剂量为50.4–55。累及淋巴结8 Gy（范围：30.6至59.4 Gy）。cT1或cT2 ASCC对总体疾病的剂量范围为50至≥60 Gy。对于cT3或cT4肿瘤，目标剂量从54 Gy到60 Gy以上，有76个（75.2％）机构规定59.4 Gy。首选的同时化疗方案是5-FU /丝裂霉素C，而有6（6％）的卡培他滨/丝裂霉素C处方。HIV阳性患者在87家医院（86.1％）接受全剂量CRT治疗。据报道，对临床反应的首次评估是在2（2％）个机构完成CRT后的4–6周，20个（19.8％）的6–8周进行的，其中79个（78％）的机构最多等待5个几个月。我们观察到ASCC患者的放射治疗剂量和治疗技术存在明显差异，HIV患者的治疗方法也存在差异。这些数据强调了针对ASCC的共识治疗指南的必要性。