TY - JOUR
T1 - Treatment volume, dose prescription and delivery techniques for dose-intensification in Rectal Cancer
T2 - A national survey
AU - Gastrointestinal Study Group of AIRO (Italian Association of Radiation Oncology and Clinical Oncology)
AU - Caravatta, Luciana
AU - Lupattelli, Marco
AU - Mantello, Giovanna
AU - Gambacorta, Maria Antonietta
AU - Chiloiro, Giuditta
AU - Di Tommaso, Monica
AU - Rosa, Consuelo
AU - Gasparini, Lucrezia
AU - Morganti, Alessio Giuseppe
AU - Picardi, Vincenzo
AU - Niespolo, Rita Marina
AU - Osti, Mattia Falchetto
AU - Montrone, Sabrina
AU - Simoni, Nicola
AU - Boso, Caterina
AU - Facchin, Francesca
AU - Deidda, Maria Assunta
AU - Piva, Cristina
AU - Guida, Cesare
AU - Ziccarelli, Luigi
AU - Munoz, Fernando
AU - Ivaldi, Giovanni Battista
AU - Marchetti, Vania
AU - Franzone, Paola
AU - Spatola, Corrado
AU - Franco, Pierfrancesco
AU - Donato, Vittorio
AU - Genovesi, Domenico
N1 - Publisher Copyright:
© 2021 International Institute of Anticancer Research. All rights reserved.
PY - 2021/4
Y1 - 2021/4
N2 - Background/Aim: The aim of the study was to investigate boost volume definition, doses, and delivery techniques for rectal cancer dose intensification. Patients and Methods: An online survey was made on 25 items (characteristics, simulation, imaging, volumes, doses, planning and treatment). Results: Thirty-eight radiation oncologists joined the study. Twenty-one delivered long-course radiotherapy with dose intensification. Boost volume was delineated on diagnostic magnetic resonance imaging (MRI) in 18 centres (85.7%), and computed tomography (CT) and/or positron emission tomography-CT in 9 (42.8%); 16 centres (76.2%) performed co-registration with CT-simulation. Boost dose was delivered on gross tumor volume in 10 centres (47.6%) and on clinical target volume in 11 (52.4%). The most common total dose was 54-55 Gy (71.4%), with moderate hypofractionation (85.7%). Intensity-modulated radiotherapy (IMRT) was used in all centres, with simultaneous integrated boost in 17 (80.8%) and image-guidance in 18 (85.7%). Conclusion: A high quality of treatment using dose escalation can be inferred by widespread multidisciplinary discussion, MRI-based treatment volume delineation, and radiation delivery relying on IMRT with accurate image-guided radiation therapy protocols.
AB - Background/Aim: The aim of the study was to investigate boost volume definition, doses, and delivery techniques for rectal cancer dose intensification. Patients and Methods: An online survey was made on 25 items (characteristics, simulation, imaging, volumes, doses, planning and treatment). Results: Thirty-eight radiation oncologists joined the study. Twenty-one delivered long-course radiotherapy with dose intensification. Boost volume was delineated on diagnostic magnetic resonance imaging (MRI) in 18 centres (85.7%), and computed tomography (CT) and/or positron emission tomography-CT in 9 (42.8%); 16 centres (76.2%) performed co-registration with CT-simulation. Boost dose was delivered on gross tumor volume in 10 centres (47.6%) and on clinical target volume in 11 (52.4%). The most common total dose was 54-55 Gy (71.4%), with moderate hypofractionation (85.7%). Intensity-modulated radiotherapy (IMRT) was used in all centres, with simultaneous integrated boost in 17 (80.8%) and image-guidance in 18 (85.7%). Conclusion: A high quality of treatment using dose escalation can be inferred by widespread multidisciplinary discussion, MRI-based treatment volume delineation, and radiation delivery relying on IMRT with accurate image-guided radiation therapy protocols.
KW - Dose intensification
KW - Gross tumor volume
KW - Intensity modulated radiotherapy
KW - Rectal cancer
KW - Simultaneous integrated boost
UR - http://www.scopus.com/inward/record.url?scp=85103921391&partnerID=8YFLogxK
U2 - 10.21873/anticanres.14966
DO - 10.21873/anticanres.14966
M3 - Article
SN - 0250-7005
VL - 41
SP - 1985
EP - 1995
JO - Anticancer Research
JF - Anticancer Research
IS - 4
ER -
