Trial Information

A Pilot Feasibility Study of Definitive Concurrent Chemoradiation With Pencil Beam Scanning Proton Beam in Combination With 5-Fluorouracil and Mitomycin-C for Carcinoma of the Anal Canal

If you agree to participate in this study, you will be asked to undergo some screening tests
or procedures to confirm that you are eligible. Many of these tests and procedures are
likely to be part of regular cancer care and may be done even if it turns out that you do
not take part in the research study. If you have had some of these tests or procedures
recently, they may or may not have to be repeated. The screening will include the following:
a medical history, physical examination, biopsy of your tumor, anal and groin exam, archival
tumor tissue, CT or PET-CT, MRI, blood tests and a serum pregnancy test. If these tests show
that you are eligible to participate in the research study, you will begin the study
treatment. If you do not meet the eligibility criteria, you will not be able to participate
in this research study.

Proton Radiation will be delivered daily for 5-6 weeks, depending on the dose prescribed by
your physician. Treatment is delivered (Monday-Friday) for 5 days (no weekends or holidays).
Each treatment will require that you lie on a table for 25-30 minutes.

You will receive radiation therapy as an outpatient at the Massachusetts General Hospital.

You will start receiving chemotherapy within 3 days of starting radiation treatment. The day
you start chemotherapy will be considered Day 1.

You will receive Mitomycin-C on Days 1 and 29 of chemotherapy. Mitomycin-C will be delivered
via IV infusion over a period of 10-30 minutes.

You will receive 5-fluorouracil on Day 1 and 29 of chemotherapy. You will be fitted with an
ambulatory infusion pump that will administer 5-FU via IV infusion continuously over a
period of 96 hours. The infusion pump will be about the size of a paperback book that can
fit into a front-pack or "fanny-pack" around your waist. This pump will be connected to your
body. The nurses in the infusion room will start the pump and disconnect it after 4 days.

At your 6 and 12 week follow up visits, a physical examination and the tests and procedures
you receive will tell your study doctor whether your disease has gotten better, worse or
stayed the same.

If your cancer has gotten better, you will continue to be monitored at your follow up
visits.

If your cancer is suspected to have gotten worse, you will need to have a biopsy to confirm.
If the biopsy is negative, you will need to come back for re-evaluation at 16 weeks (about 4
months) after completing radiation therapy.

If the biopsy confirms that your cancer has gotten worse, your doctor will recommend that
you have surgery for the removal of your tumor.

If your cancer has stayed the same, your doctor will recommend that you have additional
procedures done to develop a plan for treatment.

After you complete radiation therapy, you will be followed for up to 5 years.