Treatment Volume, Dose Prescription and Delivery Techniques for Dose-intensification in Rectal Cancer: A National Survey

Gastrointestinal Study Group of AIRO (Italian Association of Radiation Oncology and Clinical Oncology)

doi:10.21873/anticanres.14966

Treatment Volume, Dose Prescription and Delivery Techniques for Dose-intensification in Rectal Cancer: A National Survey

Gastrointestinal Study Group of AIRO (Italian Association of Radiation Oncology and Clinical Oncology)

Research output: Contribution to journal › Article › peer-review

Abstract

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.

Original language	English
Pages (from-to)	1985-1995
Number of pages	11
Journal	Anticancer Research
Volume	41
Issue number	4
DOIs	https://doi.org/10.21873/anticanres.14966
Publication status	Published - Apr 2021

Keywords

Female
Humans
Italy/epidemiology
Lymphatic Metastasis
Magnetic Resonance Imaging
Male
Neoplasm Staging
Positron Emission Tomography Computed Tomography
Positron-Emission Tomography
Practice Patterns, Physicians'/statistics & numerical data
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted/adverse effects
Radiotherapy, Image-Guided/adverse effects
Radiotherapy, Intensity-Modulated/adverse effects
Rectal Neoplasms/diagnosis
Surveys and Questionnaires
Survival Analysis
Tumor Burden/physiology

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10.21873/anticanres.14966

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@article{777c3829ab174263af4b33153a2a6d5e,

title = "Treatment Volume, Dose Prescription and Delivery Techniques for Dose-intensification in Rectal Cancer: A National Survey",

abstract = "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.",

keywords = "Female, Humans, Italy/epidemiology, Lymphatic Metastasis, Magnetic Resonance Imaging, Male, Neoplasm Staging, Positron Emission Tomography Computed Tomography, Positron-Emission Tomography, Practice Patterns, Physicians'/statistics & numerical data, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted/adverse effects, Radiotherapy, Image-Guided/adverse effects, Radiotherapy, Intensity-Modulated/adverse effects, Rectal Neoplasms/diagnosis, Surveys and Questionnaires, Survival Analysis, Tumor Burden/physiology",

author = "{Gastrointestinal Study Group of AIRO (Italian Association of Radiation Oncology and Clinical Oncology)} and Luciana Caravatta and Marco Lupattelli and Giovanna Mantello and Gambacorta, {Maria Antonietta} and Giuditta Chiloiro and {DI Tommaso}, Monica and Consuelo Rosa and Lucrezia Gasparini and Morganti, {Alessio Giuseppe} and Vincenzo Picardi and Niespolo, {Rita Marina} and Osti, {Mattia Falchetto} and Sabrina Montrone and Nicola Simoni and Caterina Boso and Francesca Facchin and Deidda, {Maria Assunta} and Cristina Piva and Cesare Guida and Luigi Ziccarelli and Fernando Munoz and Ivaldi, {Giovanni Battista} and Vania Marchetti and Paola Franzone and Corrado Spatola and Pierfrancesco Franco and Vittorio Donato and Domenico Genovesi",

year = "2021",

month = apr,

doi = "10.21873/anticanres.14966",

language = "English",

volume = "41",

pages = "1985--1995",

journal = "Anticancer Research",

issn = "0250-7005",

publisher = "International Institute of Anticancer Research",

number = "4",

}

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

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 -

Treatment Volume, Dose Prescription and Delivery Techniques for Dose-intensification in Rectal Cancer: A National Survey

Abstract

Keywords

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