A Dosimetric Analysis of Preoperative Intensity-modulated and Image-guided Radiation Therapy with and without Simultaneous Integrated Boost for Locally Advanced Rectal Cancer

Yang, Yongqiang; Feng, Long; Wang, Yunlai; Ge, Ruigang; Gong, Huijie; Xie, Chiyu; Wang, Jin‐Yuan; Chen, Jing; Lan, Yuling; Ma, Lin

doi:10.7785/tcrt.2012.500442

Cited by 5 publications

(4 citation statements)

References 28 publications

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“…For the bladder, the V40 was 66.5% in Droge et al (2015) and the Dmean was (24.8 ± 31.82) Gy in Kaplan et al (2019). For doses greater than 30 Gy, VMAT also showed a clear advantage in bladder preservation (Yang et al, 2015). In our series, the bladder V40% and Dmean were respectively (33.01 ± 18.82) Gy and (27.89 ± 13.08) Gy.…”

Section: Organs At Risk (Oar)supporting

confidence: 49%

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2020

IRJMBS

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The aim of this study was to evaluate the dosimetric results of patients treated by arc-therapy for rectal cancer at Al Kindy Oncology Center in Casablanca, Morocco. Twenty-five patients with locally advanced rectal cancer (T3, T4, N1, N2) treated by arc-therapy at doses of 46 Gy with a boost of 4 Gy sequentially or simultaneously integrated were collected. We analyzed and compared the dosimetric data of the two techniques using the dose volume histograms as well as the indices of conformity and homogeneity. Statistical analysis was performed using the SPSS v23 system (IBM Inc., Chicago, IL). Arc-therapy with simultaneous or sequential integrated boost allowed better coverage of target volumes. In fact, the D2% and D98% were (104.66 ± 0.50) and (96.62 ± 0.78), respectively. The homogeneity index was (0.078 ± 0.018) and the conformity index was (0.99 ± 0.015). For organs at risk, V30%, V40% and V50% were respectively (15.97 ± 12.97), (7.99 ± 9.15) and (2.36 ± 5.89) for the small bowel. When at the average dose, it was 13.38 Gy. The bladder was largely protected with a V40% of (33.01 ± 18.82) and an average dose of (27.89 ± 13.07) Gy. The V40% of the femoral heads was (3.68 ± 8.25). A comparison of the simultaneous integrated boost with the sequential boost showed that the coverage of the PTVs was similar. For organs at risk, the simultaneous integrated boost has very significantly (P <0.05) reduced doses in the small bowel. For the bladder and femoral heads the results of both techniques were similar. This study clearly shows that the Volumetric Modulated Arc Therapy (VMAT) technique provides a better dose distribution for PTV and OARs. The simultaneous integrated boost reduced the irradiated volumes of the small bowel resulting in a reduction in complications and toxicities.

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Section: Organs At Risk (Oar)supporting

confidence: 49%

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2020

IRJMBS

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“…[ 13 ] It is recommended that the pelvic dose is DT 45.0–50.4 Gy/25–28 times, and conventional fractionated radiation is recommended for advanced rectal cancer. [ 14 ]…”

Section: The Current Status Of Treatment In Chinamentioning

confidence: 99%

The current status of treatment for colorectal cancer in China

2017

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Background:Colorectal cancer (CRC) is one of the most common cancers all over the world, but its epidemiology is obviously different in various regions.Methods:The treatment of CRC also has varying characteristics due to differences in economy, geography, disease onset, chemotherapy, and other factors, although international guidelines are used to guide the treatment of CRC in China.Results:This paper summarizes the current status of CRC treatment, including surgical therapy, neoadjuvant radiotherapy and chemotherapy, postoperative chemotherapy, targeted therapy, maintenance therapy, and immunotherapy, according to the clinical situation in China, so as to provide better therapy and improve clinical practice for patients with CRC.Conclusion:This research shows that the treatment of colorectal cancer continues to progress, and the patient's efficacy and quality of life have improved.

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“…[7][8][9] The theoretical rationale for using such highly conformal techniques is sound for rectal cancer; however, the potential clinical benefits remain debatable. 10 Thus, we performed searches on PubMed, EMBASE, and MEDLINE databases (2000 to May 2019) using the medical subject heading term 'rectal cancer.' Additional keywords included 'preoperative,' 'radiotherapy,' 'chemoradiotherapy,' 'surgery,' 'dose,' and 'time interval.'…”

Section: Introductionmentioning

confidence: 99%

“…7–9 The theoretical rationale for using such highly conformal techniques is sound for rectal cancer; however, the potential clinical benefits remain debatable. 10 Thus, we performed searches on PubMed, EMBASE, and MEDLINE databases (2000 to May 2019) using the medical subject heading term ‘rectal cancer.’ Additional keywords included ‘preoperative,’ ‘radiotherapy,’ ‘chemoradiotherapy,’ ‘surgery,’ ‘dose,’ and ‘time interval.’ Furthermore, we reviewed reference lists from retrieved articles and textbooks to identify additional articles of interest. We discussed the options of both dose–time fractionation schedule and time to surgery using prior standards (i.e.…”

Section: Introductionmentioning

confidence: 99%

Dose–time fractionation schedules of preoperative radiotherapy and timing to surgery for rectal cancer

et al. 2020

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Chemoradiotherapy (CRT) is extensively used prior to surgery for rectal cancer to provide significantly better local control, but the radiotherapy (RT), as the other component of CRT, has been subject to less interest than the drug component in recent years. With considerable developments in RT, the use of advanced techniques, such as intensity-modulated radiotherapy (IMRT) in rectal cancer, is garnering more attention nowadays. The radiation dose can be better conformed to the target volumes with possibilities for synchronous integrated boost without increased complications in normal tissue. Hopefully, both local recurrence and toxicities can be further reduced. Although those seem to be of interest, many issues remain unresolved. There is no international consensus regarding the radiation schedule for preoperative RT for rectal cancer. Moreover, an enormous disparity exists regarding the RT delivery. With the advent of IMRT, variations will likely increase. Moreover, time to surgery is also quite variable, as it depends upon the indication for RT/CRT in the clinical practices. In this review, we discuss the options and problems related to both the dose–time fractionation schedule and time to surgery; furthermore, it addresses the research questions that need answering in the future.

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A Dosimetric Analysis of Preoperative Intensity-modulated and Image-guided Radiation Therapy with and without Simultaneous Integrated Boost for Locally Advanced Rectal Cancer

Cited by 5 publications

References 28 publications

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The current status of treatment for colorectal cancer in China

Dose–time fractionation schedules of preoperative radiotherapy and timing to surgery for rectal cancer

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