Treatment planning for colorectal cancer: radiation and surgical techniques and value of small-bowel films

IGRT in rectal cancer

“…Two-dimensional technique refers to bony anatomy as surrogate landmarks to define the field limits. It can be realized either through anterior-posterior parallel-opposed fields or a three-field technique with a posterior and two lateral portals or a fourfield technique consisting of an anterior, a posterior and two lateral portals [46]. Nevertheless, as already has been described in studies on gynaecological malignancies [47Á49] the pelvic 2D standard irradiation may provide an inadequate coverage of the target volumes and increased normal tissue complications.…”

“…A 2D TP and a 3D TP were made for each of the 30 patients enrolled. The 2D TP followed the bone anatomy according to the Gunderson guidelines [46]. The T3 PTV encompassed the entire mesorectum, the obturator nodes and the internal iliac nodes.…”

Effect of timing of surgery on survival after preoperative hyperfractionated accelerated radiotherapy (HART) for locally advanced rectal cancer (LARC): Is it a matter of days?

“…The AP-PA fields are completed with two lateral fields with the same upper and lower limits. The posterior limit of the lateral field are set behind the sacrum, whereas the anterior limit is located 3 cm anteriorly to the most anterior extension of the tumor as defined on CT. Individualized blocks are designed to exclude small bowel as much as possible from the radiation portals [22]. Inclusion of the external iliac nodes within the clinical target volume (CTV) -in contrast to internal iliac nodes -is not a protocol requirement.…”

CPT-11 and concomitant hyperfractionated accelerated radiotherapy induce efficient local control in rectal cancer patients: results from a phase II

“…All fields were to be treated during each fraction. The field margins were defined according to a 'standard field' as described by Gunderson et al (1985). The upper limit was the lower level of the fifth lumbar vertebrae and the lateral margins were 1.5 cm lateral to the pelvic bone on both sides.…”