The Use of “QUAD Shot” in Anal Canal Squamous Cell Carcinoma: A Case Study With Review of the Literature

Context: Patients with locoregional anal carcinoma who do not qualify for standard definitive chemoradiation are candidates for a short course of palliative hypofractionated radiotherapy such as QUAD Shot. Methods: A 57-year-old man with massive locoregional squamous cell carcinoma of the anal canal was treated with QUAD Shot (14.8 Gy in four fractions over two consecutive days) repeated every four weeks for a total of two courses. Results: He reported symptomatic relief following each course of radiation. In regard to his first QUAD Shot, his pain was 10/10 in severity at the time of admission and 4/10 at the time of discharge. In regard to his second QUAD Shot, his pain was 8/10 at the time of admission and 0/10 at the time of discharge. He did not experience any treatment-related toxicity. He passed away 15 weeks after the first course. Conclusion: QUAD Shot is both efficacious and safe for palliation in patients with anal carcinoma.