Editor-in-Chief Emeritus Pick of Papers
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For each issue of Radiotherapy and Oncology, the Editor-in-Chief Emeritus Jens Overgaard, picks his favourite papers.
- Anal cancer (AC) is an uncommon disease, yet over the past decade the incidence of anal cancer has increased by 2.2% each year . Development of anal cancer is strongly associated with the presence of human papilloma virus (HPV) infection, with >90% of anal cancers directly attributed to HPV .
- With annual incidence of 0.5 per 100,000, anal cancer accounts for <3% of lower gastrointestinal tract malignancies [1,2]. It is more common in immunocompromised patients and smokers . Rise of incidence over past decades  can be attributed to the increased prevalence of HPV infection which is the most important cause [3,5]. Abdominoperineal resection was the main treatment in the past, but resulted in suboptimal locoregional control and high morbidity due to sphincter loss . Following encouraging first experience with chemoradiation [7,8], its effectiveness was confirmed by several retrospective and phase II studies [9–13].
- Anal squamous cell carcinoma (ASCC) is a rare tumor entity with a steady rise in incidence . Primary chemoradiotherapy (CRT) with 5-fluorouracil and mitomycin C (5-FU/MMC) remains the standard treatment for localized disease since the introduction of this treatment approach by Nigro et al. in the 1980s . Radical surgery with abdominoperineal resection and a permanent colostomy is now reserved for patients with locally persistent or recurrent disease after CRT. The addition of sequential chemotherapy, either prior to or following primary CRT, or dose escalation of radiotherapy was tested in several randomized trials, but failed to improve oncological results [3–5].
- Human papillomaviruses (HPVs) are small double-stranded DNA viruses that pose significant public health concerns as the causative agent of approximately 5% of worldwide cancers. The HPV oncogenes E6 and E7 play key roles in carcinogenesis. In the last 15 years there has been a significant increase in the incidence of HPV-related head and neck cancers arising primarily in the oropharynx. Patients with HPV-positive head and neck cancers (HNCs) have a significantly improved prognosis compared to those with HPV-negative disease.