TY - JOUR
T1 - Treatment Volume, Dose Prescription and Delivery Techniques for Dose-intensification in Rectal Cancer: A National Survey
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
AU - Gastrointestinal Study Group of AIRO (Italian Association of Radiation Oncology and Clinical Oncology)
N1 - Copyright © 2021 International Institute of Anticancer Research (Dr. George J. Delinasios), 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 - Female
KW - Humans
KW - Italy/epidemiology
KW - Lymphatic Metastasis
KW - Magnetic Resonance Imaging
KW - Male
KW - Neoplasm Staging
KW - Positron Emission Tomography Computed Tomography
KW - Positron-Emission Tomography
KW - Practice Patterns, Physicians'/statistics & numerical data
KW - Radiotherapy Dosage
KW - Radiotherapy Planning, Computer-Assisted/adverse effects
KW - Radiotherapy, Image-Guided/adverse effects
KW - Radiotherapy, Intensity-Modulated/adverse effects
KW - Rectal Neoplasms/diagnosis
KW - Surveys and Questionnaires
KW - Survival Analysis
KW - Tumor Burden/physiology
U2 - 10.21873/anticanres.14966
DO - 10.21873/anticanres.14966
M3 - Article
C2 - 33813405
VL - 41
SP - 1985
EP - 1995
JO - Anticancer Research
JF - Anticancer Research
SN - 0250-7005
IS - 4
ER -