A patient with locally advanced anal squamous cell carcinoma (T3N0M0) is treated with the Nigro protocol. What are the three components of this regimen?

• A Cisplatin + 5-FU + radiotherapy (50 Gy)
• B 5-FU + oxaliplatin + surgery
• C Capecitabine + irinotecan + radiotherapy
• D 5-FU + mitomycin C + radiotherapy (30 Gy) ✓

Explanation

The Nigro protocol, originally described in 1974, consists of 5-fluorouracil (continuous infusion), mitomycin C (bolus on day 1), and radiotherapy to 30 Gy. This regimen achieved high rates of clinical complete response and became the cornerstone of definitive chemoradiotherapy for anal canal carcinoma, largely replacing abdominoperineal resection. Modern protocols use higher radiation doses (45–54 Gy) while retaining the same chemotherapy backbone.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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