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.
- Lymphatic Metastasis
- Magnetic Resonance Imaging
- 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