{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T15:03:22Z","timestamp":1784559802767,"version":"3.55.0"},"reference-count":82,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,2,2]],"date-time":"2025-02-02T00:00:00Z","timestamp":1738454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","esmogastro.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["ESMO Gastrointestinal Oncology"],"published-print":{"date-parts":[[2026,7]]},"DOI":"10.1016\/j.esmogo.2025.100149","type":"journal-article","created":{"date-parts":[[2025,3,8]],"date-time":"2025-03-08T18:40:03Z","timestamp":1741459203000},"page":"100149","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"special_numbering":"PA","title":["Innovative radiotherapy approaches"],"prefix":"10.1016","volume":"13","author":[{"given":"G.","family":"Chiloiro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2276-0687","authenticated-orcid":false,"given":"P.","family":"Franco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7419-6750","authenticated-orcid":false,"given":"M.P.","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9371-9951","authenticated-orcid":false,"given":"A.","family":"Romano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6851-2086","authenticated-orcid":false,"given":"E.","family":"Serup-Hansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Fionda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Manfrida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Kronborg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.A.","family":"Gambacorta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"9","key":"10.1016\/j.esmogo.2025.100149_bib1","doi-asserted-by":"crossref","first-page":"2527","DOI":"10.1200\/JCO.1996.14.9.2527","article-title":"Role of mitomycin in combination with fluorouracil and radiotherapy, and of salvage chemoradiation in the definitive nonsurgical treatment of epidermoid carcinoma of the anal canal: results of a phase III randomized intergroup study","volume":"14","author":"Flam","year":"1996","journal-title":"J Clin Oncol"},{"issue":"7","key":"10.1016\/j.esmogo.2025.100149_bib2","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1038\/sj.bjc.6605605","article-title":"Chemoradiation for the treatment of epidermoid anal cancer: 13-year follow-up of the first randomised UKCCCR Anal Cancer Trial (ACT I)","volume":"102","author":"Northover","year":"2010","journal-title":"Br J Cancer"},{"issue":"9034","key":"10.1016\/j.esmogo.2025.100149_bib3","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/S0140-6736(96)03409-5","article-title":"Epidermoid anal cancer: results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycin. UKCCCR Anal Cancer Trial Working Party. UK Co-ordinating Committee on Cancer Research","volume":"348","year":"1996","journal-title":"Lancet"},{"issue":"5","key":"10.1016\/j.esmogo.2025.100149_bib4","doi-asserted-by":"crossref","first-page":"2040","DOI":"10.1200\/JCO.1997.15.5.2040","volume":"15","author":"Bartelink","year":"1997","journal-title":"J Clin Oncol"},{"issue":"17","key":"10.1016\/j.esmogo.2025.100149_bib5","doi-asserted-by":"crossref","first-page":"4007","DOI":"10.1002\/cncr.25188","article-title":"Prognostic factors derived from a prospective database dictate clinical biology of anal cancer: the intergroup trial (RTOG 98-11)","volume":"116","author":"Ajani","year":"2010","journal-title":"Cancer"},{"issue":"16","key":"10.1016\/j.esmogo.2025.100149_bib6","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1200\/JCO.2011.35.4837","article-title":"Induction chemotherapy and dose intensification of the radiation boost in locally advanced anal canal carcinoma: final analysis of the randomized UNICANCER ACCORD 03 trial","volume":"30","author":"Peiffert","year":"2012","journal-title":"J Clin Oncol"},{"issue":"6","key":"10.1016\/j.esmogo.2025.100149_bib7","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/S1470-2045(13)70086-X","article-title":"Mitomycin or cisplatin chemoradiation with or without maintenance chemotherapy for treatment of squamous-cell carcinoma of the anus (ACT II): a randomised, phase 3, open-label, 2 \u00d7 2 factorial trial","volume":"14","author":"James","year":"2013","journal-title":"Lancet Oncol"},{"issue":"4","key":"10.1016\/j.esmogo.2025.100149_bib8","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1016\/j.ijrobp.2009.09.029","article-title":"Squamous cell carcinoma of the anal canal: patterns and predictors of failure and implications for intensity-modulated radiation treatment planning","volume":"78","author":"Wright","year":"2010","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"3","key":"10.1016\/j.esmogo.2025.100149_bib9","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.ijrobp.2006.12.052","article-title":"Predictors and patterns of recurrence after definitive chemoradiation for anal cancer","volume":"68","author":"Das","year":"2007","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"10.1016\/j.esmogo.2025.100149_bib10","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.ijrobp.2012.09.023","article-title":"RTOG 0529: a phase 2 evaluation of dose-painted intensity modulated radiation therapy in combination with 5-fluorouracil and mitomycin-C for the reduction of acute morbidity in carcinoma of the anal canal","volume":"86","author":"Kachnic","year":"2013","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.esmogo.2025.100149_bib11","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ejca.2019.12.022","article-title":"UK national cohort of anal cancer treated with intensity-modulated radiotherapy: one-year oncological and patient-reported outcomes","volume":"128","author":"Gilbert","year":"2020","journal-title":"Eur J Cancer"},{"key":"10.1016\/j.esmogo.2025.100149_bib12","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.radonc.2021.01.027","article-title":"Anorectal function and radiation dose to pelvic floor muscles after primary treatment for anal cancer","volume":"157","author":"Kronborg","year":"2021","journal-title":"Radiother Oncol"},{"issue":"2","key":"10.1016\/j.esmogo.2025.100149_bib13","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.radonc.2018.06.006","article-title":"Prospective evaluation of acute toxicity and patient reported outcomes in anal cancer and plan optimization","volume":"128","author":"Kronborg","year":"2018","journal-title":"Radiother Oncol"},{"issue":"35","key":"10.1016\/j.esmogo.2025.100149_bib14","doi-asserted-by":"crossref","first-page":"4344","DOI":"10.1200\/JCO.2012.43.8085","article-title":"Long-term update of US GI intergroup RTOG 98-11 phase III trial for anal carcinoma: survival, relapse, and colostomy failure with concurrent chemoradiation involving fluorouracil\/mitomycin versus fluorouracil\/cisplatin","volume":"30","author":"Gunderson","year":"2012","journal-title":"J Clin Oncol"},{"issue":"1","key":"10.1016\/j.esmogo.2025.100149_bib15","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.soc.2016.07.004","article-title":"Evolution and management of treatment-related toxicity in anal cancer","volume":"26","author":"Ludmir","year":"2017","journal-title":"Surg Oncol Clin N Am"},{"issue":"3","key":"10.1016\/j.esmogo.2025.100149_bib16","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1111\/ajco.12768","article-title":"Image-guided IMRT with simultaneous integrated boost as per RTOG 0529 for the treatment of anal cancer","volume":"14","author":"Arcadipane","year":"2018","journal-title":"Asia Pac J Clin Oncol"},{"issue":"1","key":"10.1016\/j.esmogo.2025.100149_bib17","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/COC.0000000000000009","article-title":"Intensity-modulated radiation therapy for anal cancer: results from a multi-institutional retrospective cohort study","volume":"39","author":"Call","year":"2016","journal-title":"Am J Clin Oncol"},{"issue":"6","key":"10.1016\/j.esmogo.2025.100149_bib18","doi-asserted-by":"crossref","first-page":"259","DOI":"10.3109\/07357907.2015.1028586","article-title":"Intensity-modulated radiation therapy with simultaneous integrated boost combined with concurrent chemotherapy for the treatment of anal cancer patients: 4-year results of a consecutive case series","volume":"33","author":"Franco","year":"2015","journal-title":"Cancer Invest"},{"issue":"15","key":"10.1016\/j.esmogo.2025.100149_bib19","doi-asserted-by":"crossref","first-page":"3342","DOI":"10.1002\/cncr.25901","article-title":"Intensity-modulated radiation therapy versus conventional radiation therapy for squamous cell carcinoma of the anal canal","volume":"117","author":"Bazan","year":"2011","journal-title":"Cancer"},{"issue":"4","key":"10.1016\/j.esmogo.2025.100149_bib20","first-page":"279","article-title":"Treatment of squamous cell carcinoma of the anus, unresolved areas and future perspectives for research: perspectives of research needs in anal cancer","volume":"20","author":"Guren","year":"2021","journal-title":"Clin Colorectal Cancer"},{"issue":"7","key":"10.1016\/j.esmogo.2025.100149_bib21","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.3390\/cancers14071697","article-title":"A machine-learning-based bibliometric analysis of the scientific literature on anal cancer","volume":"14","author":"Franco","year":"2022","journal-title":"Cancers (Basel)"},{"issue":"1","key":"10.1016\/j.esmogo.2025.100149_bib22","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.ijrobp.2021.08.008","article-title":"Long-term outcomes of NRG oncology\/RTOG 0529: a phase 2 evaluation of dose-painted intensity modulated radiation therapy in combination with 5-fluorouracil and mitomycin-C for the reduction of acute morbidity in anal canal cancer","volume":"112","author":"Kachnic","year":"2022","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"12","key":"10.1016\/j.esmogo.2025.100149_bib23","first-page":"3613","article-title":"Systematic review of the quality of life issues associated with anal cancer and its treatment with radiochemotherapy","volume":"23","author":"Sodergren","year":"2015","journal-title":"Support Care Cancer"},{"issue":"5","key":"10.1016\/j.esmogo.2025.100149_bib24","doi-asserted-by":"crossref","first-page":"427","DOI":"10.3390\/jpm11050427","article-title":"Concurrent chemoradiation in anal cancer patients delivered with bone marrow-sparing IMRT: final results of a prospective phase II trial","volume":"11","author":"Arcadipane","year":"2021","journal-title":"J Pers Med"},{"key":"10.1016\/j.esmogo.2025.100149_bib25","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.radonc.2022.09.015","article-title":"Online adaptive radiotherapy of anal cancer: normal tissue sparing, target propagation methods, and first clinical experience","volume":"176","author":"\u00c5str\u00f6m","year":"2022","journal-title":"Radiother Oncol"},{"issue":"9","key":"10.1016\/j.esmogo.2025.100149_bib26","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/j.annonc.2021.06.015","article-title":"Anal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"32","author":"Rao","year":"2021","journal-title":"Ann Oncol"},{"issue":"4","key":"10.1016\/j.esmogo.2025.100149_bib27","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.prro.2022.01.015","article-title":"ECOG-ACRIN guideline for contouring and treatment of early stage anal cancer using IMRT\/IGRT","volume":"12","author":"Damico","year":"2022","journal-title":"Pract Radiat Oncol"},{"issue":"3","key":"10.1016\/j.esmogo.2025.100149_bib28","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1016\/j.ijrobp.2008.08.070","article-title":"Elective clinical target volumes for conformal therapy in anorectal cancer: a radiation therapy oncology group consensus panel contouring atlas","volume":"74","author":"Myerson","year":"2009","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"5","key":"10.1016\/j.esmogo.2025.100149_bib29","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1016\/j.ijrobp.2011.12.058","article-title":"Australasian Gastrointestinal Trials Group (AGITG) contouring atlas and planning guidelines for intensity-modulated radiotherapy in anal cancer","volume":"83","author":"Ng","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"2","key":"10.1016\/j.esmogo.2025.100149_bib30","doi-asserted-by":"crossref","first-page":"e173","DOI":"10.1016\/j.ijrobp.2011.12.062","article-title":"Chemoradiotherapy of anal carcinoma: survival and recurrence in an unselected national cohort","volume":"83","author":"Bentzen","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"10.1016\/j.esmogo.2025.100149_bib31","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1186\/s12885-021-08187-8","article-title":"Patterns of pathologic lymph nodes in anal cancer: a PET-CT-based analysis with implications for radiotherapy treatment volumes","volume":"21","author":"Frennered","year":"2021","journal-title":"BMC Cancer"},{"key":"10.1016\/j.esmogo.2025.100149_bib32","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/s13014-020-01567-7","article-title":"Patterns of recurrence in anal cancer: a detailed analysis","volume":"15","author":"Nilsson","year":"2020","journal-title":"Radiat Oncol"},{"issue":"7","key":"10.1016\/j.esmogo.2025.100149_bib33","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1080\/0284186X.2021.1918763","article-title":"Treatment outcomes and prognostic factors after chemoradiotherapy for anal cancer","volume":"60","author":"Sl\u00f8rdahl","year":"2021","journal-title":"Acta Oncol"},{"issue":"4","key":"10.1016\/j.esmogo.2025.100149_bib34","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/j.ijrobp.2019.03.020","article-title":"Importance of technique, target selection, contouring, dose prescription, and dose-planning in external beam radiation therapy for cervical cancer: evolution of practice from EMBRACE-I to II","volume":"104","author":"Berger","year":"2019","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.esmogo.2025.100149_bib35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.radonc.2019.01.018","article-title":"Selection of lymph node target volumes for definitive head and neck radiation therapy: a 2019 update","volume":"134","author":"Biau","year":"2019","journal-title":"Radiother Oncol"},{"issue":"2","key":"10.1016\/j.esmogo.2025.100149_bib36","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.radonc.2016.07.017","article-title":"International consensus guidelines on clinical target volume delineation in rectal cancer","volume":"120","author":"Valentini","year":"2016","journal-title":"Radiother Oncol"},{"issue":"8","key":"10.1016\/j.esmogo.2025.100149_bib37","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1080\/0284186X.2023.2240490","article-title":"Nordic anal cancer (NOAC) group consensus guidelines for risk-adapted delineation of the elective clinical target volume in anal cancer","volume":"62","author":"Nilsson","year":"2023","journal-title":"Acta Oncol"},{"issue":"24","key":"10.1016\/j.esmogo.2025.100149_bib38","doi-asserted-by":"crossref","first-page":"5833","DOI":"10.3390\/cancers15245833","article-title":"Nodal elective volume selection and definition during radiation therapy for early stage (T1\u2013T2 N0 M0) perianal squamous cell carcinoma: a narrative clinical review and critical appraisal","volume":"15","author":"Spinelli","year":"2023","journal-title":"Cancers"},{"issue":"6","key":"10.1016\/j.esmogo.2025.100149_bib39","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1001\/jamaoncol.2020.0809","article-title":"Factors associated with chemoradiation therapy interruption and noncompletion among patients with squamous cell anal carcinoma","volume":"6","author":"Raphael","year":"2020","journal-title":"JAMA Oncol"},{"issue":"3","key":"10.1016\/j.esmogo.2025.100149_bib40","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.21873\/invivo.13570","article-title":"High-tailored anal canal radiotherapy (HIT-ART): outcomes of a 10-year single center clinical experience","volume":"38","author":"Manfrida","year":"2024","journal-title":"In Vivo"},{"issue":"suppl 2","key":"10.1016\/j.esmogo.2025.100149_bib41","doi-asserted-by":"crossref","first-page":"E164","DOI":"10.1016\/j.ijrobp.2016.06.1006","article-title":"The development of an umbrella trial (PLATO) to address radiation therapy dose questions in the locoregional management of squamous cell carcinoma of the anus","volume":"96","author":"Sebag-Montefiore","year":"2016","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"10","key":"10.1016\/j.esmogo.2025.100149_bib42","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1007\/BF02234605","article-title":"HIV-positive patients with anal carcinoma have poorer treatment tolerance and outcome than HIV-negative patients","volume":"44","author":"Kim","year":"2001","journal-title":"Dis Colon Rectum"},{"issue":"1","key":"10.1016\/j.esmogo.2025.100149_bib43","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.radonc.2016.08.011","article-title":"Quantifying target-specific motion in anal cancer patients treated with intensity modulated radiotherapy (IMRT)","volume":"121","author":"Durrant","year":"2016","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.esmogo.2025.100149_bib44","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.phro.2020.12.004","article-title":"Clinical implementation of artificial intelligence-driven cone-beam computed tomography-guided online adaptive radiotherapy in the pelvic region","volume":"17","author":"Sibolt","year":"2021","journal-title":"Phys Imaging Radiat Oncol"},{"issue":"1","key":"10.1016\/j.esmogo.2025.100149_bib45","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1186\/s13014-021-01866-7","article-title":"Feasibility of Conebeam CT-based online adaptive radiotherapy for neoadjuvant treatment of rectal cancer","volume":"16","author":"de Jong","year":"2021","journal-title":"Radiat Oncol"},{"issue":"1","key":"10.1016\/j.esmogo.2025.100149_bib46","doi-asserted-by":"crossref","first-page":"e13479","DOI":"10.1002\/acm2.13479","article-title":"Varian ethos online adaptive radiotherapy for prostate cancer: early results of contouring accuracy, treatment plan quality, and treatment time","volume":"23","author":"Byrne","year":"2022","journal-title":"J Appl Clin Med Phys"},{"key":"10.1016\/j.esmogo.2025.100149_bib47","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.tipsro.2022.04.001","article-title":"Evaluation of an automated template-based treatment planning system for radiotherapy of anal, rectal and prostate cancer","volume":"22","author":"Calmels","year":"2022","journal-title":"Tech Innov Patient Support Radiat Oncol"},{"issue":"1","key":"10.1016\/j.esmogo.2025.100149_bib48","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.semradonc.2023.10.004","article-title":"Rectal cancer MRI guided radiotherapy: a practical review for the physician","volume":"34","author":"Chiloiro","year":"2024","journal-title":"Semin Radiat Oncol"},{"issue":"4","key":"10.1016\/j.esmogo.2025.100149_bib49","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1007\/s00330-017-5133-0","article-title":"The impact of MRI sequence on tumour staging and gross tumour volume delineation in squamous cell carcinoma of the anal canal","volume":"28","author":"Prezzi","year":"2018","journal-title":"Eur Radiol"},{"issue":"1","key":"10.1016\/j.esmogo.2025.100149_bib50","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/jicru_ndq001","article-title":"The International Commission on Radiation Units and Measurements","volume":"10","year":"2010","journal-title":"J ICRU"},{"key":"10.1016\/j.esmogo.2025.100149_bib51","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.radonc.2020.06.012","article-title":"Gross tumour volume delineation in anal cancer on T2-weighted and diffusion-weighted MRI - reproducibility between radiologists and radiation oncologists and impact of reader experience level and DWI image quality","volume":"150","author":"Min","year":"2020","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.esmogo.2025.100149_bib52","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1186\/s12885-015-1244-7","article-title":"Multiparametric MRI as an outcome predictor for anal canal cancer managed with chemoradiotherapy","volume":"15","author":"Jones","year":"2015","journal-title":"BMC Cancer"},{"key":"10.1016\/j.esmogo.2025.100149_bib53","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.radonc.2022.07.001","article-title":"Evaluation of early regression index as response predictor in cervical cancer: a retrospective study on T2 and DWI MR images","volume":"174","author":"Cusumano","year":"2022","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.esmogo.2025.100149_bib54","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/s12885-021-09158-9","article-title":"THUNDER 2: THeragnostic Utilities for Neoplastic DisEases of the Rectum by MRI guided radiotherapy","volume":"22","author":"Chiloiro","year":"2022","journal-title":"BMC Cancer"},{"key":"10.1016\/j.esmogo.2025.100149_bib55","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.radonc.2021.09.002","article-title":"A novel approach for radiotherapy dose escalation in rectal cancer using online MR-guidance and rectal ultrasound gel filling - rationale and first in human","volume":"164","author":"Gani","year":"2021","journal-title":"Radiother Oncol"},{"issue":"6","key":"10.1016\/j.esmogo.2025.100149_bib56","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1007\/s00066-014-0628-y","article-title":"Role of brachytherapy in the treatment of cancers of the anal canal. Long-term follow-up and multivariate analysis of a large monocentric retrospective series","volume":"190","author":"Lestrade","year":"2014","journal-title":"Strahlenther Onkol"},{"key":"10.1016\/j.esmogo.2025.100149_bib57","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.radonc.2022.02.006","article-title":"Anal cancer brachytherapy: from radon seeds to interstitial Papillon technique in a century. What does the future hold?","volume":"169","author":"Petric","year":"2022","journal-title":"Radiother Oncol"},{"issue":"5","key":"10.1016\/j.esmogo.2025.100149_bib58","first-page":"386","article-title":"Brachytherapy: an overview for clinicians","volume":"69","author":"Chargari","year":"2019","journal-title":"CA Cancer J Clin"},{"issue":"4","key":"10.1016\/j.esmogo.2025.100149_bib59","doi-asserted-by":"crossref","first-page":"306","DOI":"10.5114\/jcb.2024.143223","article-title":"COMIRI - COMplexity Index of interventional Radiotherapy (brachytherapy) Implants: assessment of procedures based on type, equipment, and team","volume":"16","author":"Fionda","year":"2024","journal-title":"J Contemp Brachytherapy"},{"issue":"3","key":"10.1016\/j.esmogo.2025.100149_bib60","doi-asserted-by":"crossref","first-page":"246","DOI":"10.5114\/jcb.2018.76884","article-title":"Brachytherapy boost after chemoradiation in anal cancer: a systematic review","volume":"10","author":"Frakulli","year":"2018","journal-title":"J Contemp Brachytherapy"},{"key":"10.1016\/j.esmogo.2025.100149_bib61","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.radonc.2022.03.019","article-title":"High dose rate brachytherapy in the management of anal cancer: a review","volume":"171","author":"Ali","year":"2022","journal-title":"Radiother Oncol"},{"issue":"3","key":"10.1016\/j.esmogo.2025.100149_bib62","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1016\/j.ijrobp.2010.02.055","article-title":"High-dose split-course radiation therapy for anal cancer: outcome analysis regarding the boost strategy (CORS-03 study)","volume":"80","author":"Hannoun-Levi","year":"2011","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"5","key":"10.1016\/j.esmogo.2025.100149_bib63","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1016\/j.ijrobp.2010.07.1995","article-title":"\u201cMind the gap\u201d--the impact of variations in the duration of the treatment gap and overall treatment time in the first UK Anal Cancer Trial (ACT I)","volume":"81","author":"Glynne-Jones","year":"2011","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"4","key":"10.1016\/j.esmogo.2025.100149_bib64","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.brachy.2023.03.004","article-title":"The impact of brachytherapy boost for anal canal cancers in the era of de-escalation treatments","volume":"22","author":"Varela Cagetti","year":"2023","journal-title":"Brachytherapy"},{"issue":"4","key":"10.1016\/j.esmogo.2025.100149_bib65","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1007\/s00464-004-2287-z","article-title":"Multimodal therapy of anal cancer added by new endosonographic-guided brachytherapy","volume":"20","author":"Doniec","year":"2006","journal-title":"Surg Endosc"},{"issue":"5","key":"10.1016\/j.esmogo.2025.100149_bib66","doi-asserted-by":"crossref","first-page":"336","DOI":"10.5114\/jcb.2015.55118","article-title":"MITHRA - multiparametric MR\/CT image adapted brachytherapy (MR\/CT-IABT) in anal canal cancer: a feasibility study","volume":"7","author":"Tagliaferri","year":"2015","journal-title":"J Contemp Brachytherapy"},{"key":"10.1016\/j.esmogo.2025.100149_bib67","series-title":"The GEC-ESTRO Handbook of Brachytherapy","article-title":"23. Anal cancer","author":"Gehin","year":"2023"},{"issue":"9","key":"10.1016\/j.esmogo.2025.100149_bib69","doi-asserted-by":"crossref","first-page":"2099","DOI":"10.3390\/cancers13092099","article-title":"De-escalation of therapy for patients with early-stage squamous cell carcinoma of the anus","volume":"13","author":"Miller","year":"2021","journal-title":"Cancers (Basel)"},{"issue":"2","key":"10.1016\/j.esmogo.2025.100149_bib70","doi-asserted-by":"crossref","first-page":"11","DOI":"10.14338\/IJPT-17-00017","article-title":"Dosimetric comparison of intensity-modulated proton therapy and volumetric-modulated arc therapy in anal cancer patients and the ability to spare bone marrow","volume":"4","author":"Meier","year":"2017","journal-title":"Int J Part Ther"},{"issue":"8","key":"10.1016\/j.esmogo.2025.100149_bib71","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.3109\/0284186X.2014.1002570","article-title":"Pencil-beam scanning proton therapy for anal cancer: a dosimetric comparison with intensity-modulated radiotherapy","volume":"54","author":"Ojerholm","year":"2015","journal-title":"Acta Oncol"},{"issue":"3","key":"10.1016\/j.esmogo.2025.100149_bib72","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.radonc.2015.10.027","article-title":"Scanning proton beam therapy reduces normal tissue exposure in pelvic radiotherapy for anal cancer","volume":"117","author":"Anand","year":"2015","journal-title":"Radiother Oncol"},{"issue":"1","key":"10.1016\/j.esmogo.2025.100149_bib73","doi-asserted-by":"crossref","first-page":"176","DOI":"10.21037\/jgo.2019.04.03","article-title":"Proton beam radiotherapy for anal and rectal cancers","volume":"11","author":"Vaios","year":"2020","journal-title":"J Gastrointest Oncol"},{"issue":"11","key":"10.1016\/j.esmogo.2025.100149_bib74","doi-asserted-by":"crossref","first-page":"1472","DOI":"10.1080\/0284186X.2017.1376753","article-title":"Impact of bowel gas and body outline variations on total accumulated dose with intensity-modulated proton therapy in locally advanced cervical cancer patients","volume":"56","author":"Berger","year":"2017","journal-title":"Acta Oncol"},{"issue":"6","key":"10.1016\/j.esmogo.2025.100149_bib75","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1097\/COC.0000000000000916","article-title":"Hematologic toxicity comparison of intensity modulated proton therapy and intensity modulated radiation therapy in anal cancer patients","volume":"45","author":"Nelson","year":"2022","journal-title":"Am J Clin Oncol"},{"issue":"1","key":"10.1016\/j.esmogo.2025.100149_bib76","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.ijrobp.2019.04.040","article-title":"Pencil beam scanning proton beam chemoradiation therapy with 5-fluorouracil and mitomycin-C for definitive treatment of carcinoma of the anal canal: a multi-institutional pilot feasibility study","volume":"105","author":"Wo","year":"2019","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"10.1016\/j.esmogo.2025.100149_bib78","doi-asserted-by":"crossref","first-page":"185","DOI":"10.3390\/cancers14010185","article-title":"Pencil beam scanning (PBS) intensity-modulated proton therapy (IMPT) chemoradiotherapy for anal canal cancer-single institution experience","volume":"14","author":"V\u00edtek","year":"2021","journal-title":"Cancers (Basel)"},{"issue":"3","key":"10.1016\/j.esmogo.2025.100149_bib77","doi-asserted-by":"crossref","first-page":"e146","DOI":"10.1016\/j.ijrobp.2022.07.997","article-title":"Feasibility trial of IMPT to reduce toxicity in anal cancer patients","volume":"114","author":"Nelson","year":"2022","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.esmogo.2025.100149_bib79","first-page":"59","article-title":"Definitive hyperfractionated, accelerated proton reirradiation for patients with pelvic malignancies","volume":"19","author":"Moningi","year":"2019","journal-title":"Clin Transl Radiat Oncol"},{"key":"10.1016\/j.esmogo.2025.100149_bib80","author":"Kharofa"},{"key":"10.1016\/j.esmogo.2025.100149_bib81","author":"Kharofa"},{"issue":"1","key":"10.1016\/j.esmogo.2025.100149_bib84","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1186\/s12885-024-12111-1","article-title":"ROAR-A: re-optimization based online adaptive radiotherapy of anal cancer, a prospective phase II trial protocol","volume":"24","author":"Storm","year":"2024","journal-title":"BMC Cancer"},{"key":"10.1016\/j.esmogo.2025.100149_bib85","author":"Kachnic"}],"container-title":["ESMO Gastrointestinal Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2949819825000184?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2949819825000184?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:29:07Z","timestamp":1784557747000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2949819825000184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":82,"alternative-id":["S2949819825000184"],"URL":"https:\/\/doi.org\/10.1016\/j.esmogo.2025.100149","relation":{},"ISSN":["2949-8198"],"issn-type":[{"value":"2949-8198","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Innovative radiotherapy approaches","name":"articletitle","label":"Article Title"},{"value":"ESMO Gastrointestinal Oncology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.esmogo.2025.100149","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Authors. Published by Elsevier Ltd on behalf of European Society for Medical Oncology.","name":"copyright","label":"Copyright"}],"article-number":"100149"}}