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Intensity-modulated radiation therapy (IMRT) has been used to spare organs at risk (OARs) in the definitive treatment of anal cancer. However, treatment continues to result in significant hematologic toxicity. In a cooperative trial assessing IMRT (RTOG 0529), the rate of grade 2+ and grade 3+ hematologic toxicity was 73% and 58%, respectively. Intensity-modulated proton therapy (IMPT) has the potential to decrease the integral bone marrow dose and dose to other OARs compared with photon therapy.

international journal of particle therapy

Dosimetric Comparison of Intensity-Modulated Proton Therapy and Volumetric-Modulated Arc Therapy in Anal Cancer Patients and the Ability to Spare Bone Marrow