• Neil Chevli, Gary D Lewis, and Todd A Swanson.
• Department of Radiation Oncology, University of Texas Medical Branch at Galveston, Galveston, Texas, USA.
• J Pain Symptom Manage. 2019 Feb 1; 57 (2): 341-345.

ContextPatients 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.MethodsA 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.ResultsHe 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.ConclusionQUAD Shot is both efficacious and safe for palliation in patients with anal carcinoma.Copyright © 2018. Published by Elsevier Inc.

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