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.
Caravatta, L., Lupattelli, M., Mantello, G., Gambacorta, M. A., Chiloiro, G., Di Tommaso, M., Rosa, C., Gasparini, L., Morganti, A. G., Picardi, V., Niespolo, R. M., Osti, M. F., Montrone, S., Simoni, N., Boso, C., Facchin, F., Deidda, M. A., Piva, C., Guida, C., Ziccarelli, L., Munoz, F., Ivaldi, G. B., Marchetti, V., Franzone, P., Spatola, C., Franco, P., Donato, V., Genovesi, D., Treatment volume, dose prescription and delivery techniques for dose-intensification in Rectal Cancer: A national survey, <<ANTICANCER RESEARCH>>, 2021; 41 (4): 1985-1995. [doi:10.21873/anticanres.14966] [http://hdl.handle.net/10807/198590]
Treatment volume, dose prescription and delivery techniques for dose-intensification in Rectal Cancer: A national survey
Gambacorta, Maria Antonietta;Chiloiro, Giuditta;Morganti, Alessio Giuseppe;
2021
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.
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