Intensity-modulated Radiotherapy for Rectal Cancer in the UK in 2020
| Autor: | Maria A. Hawkins, Sean M. O'Cathail, David Sebag-Montefiore, A. Duffton, Patrizia Porcu, Kirsten Laws, Alexandra Gilbert, Maxwell Robinson, Catherine Hanna, Claire Arthur, M. Beasley, Mark Beavon, Mark Harrison, Ane Appelt, Suliana Teoh, Finbar Slevin, Rebecca Muirhead, Simon Gollins, Richard Adams, M. Teo |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Colorectal cancer medicine.medical_treatment Planning target volume Dose constraints 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine Humans survey Radiology Nuclear Medicine and imaging Medical physics IMRT rectal cancer Radiation treatment planning Rectal Neoplasms business.industry Dose fractionation Radiotherapy Dosage intensity-modulated radiotherapy medicine.disease Total mesorectal excision United Kingdom Radiation therapy Oncology 030220 oncology & carcinogenesis Original Article Dose Fractionation Radiation Radiotherapy Intensity-Modulated Intensity modulated radiotherapy business neoplasm |
| Zdroj: | Clinical Oncology (Royal College of Radiologists (Great Britain) |
| ISSN: | 0936-6555 |
| DOI: | 10.1016/j.clon.2020.12.011 |
| Popis: | Aims Preoperative (chemo)radiotherapy followed by total mesorectal excision is the current standard of care for patients with locally advanced rectal cancer. The use of intensity-modulated radiotherapy (IMRT) for rectal cancer is increasing in the UK. However, the extent of IMRT implementation and current practice was not previously known. A national survey was commissioned to investigate the landscape of IMRT use for rectal cancer and to inform the development of national rectal cancer IMRT guidance. Materials and methods A web-based survey was developed by the National Rectal Cancer IMRT Guidance working group in collaboration with the Royal College of Radiologists and disseminated to all UK radiotherapy centres. The survey enquired about the implementation of IMRT with a focus on the following aspects of the workflow: dose fractionation schedules and use of a boost; pre-treatment preparation and simulation; target volume/organ at risk definition; treatment planning and treatment verification. A descriptive statistical analysis was carried out. Results In total, 44 of 63 centres (70%) responded to the survey; 30/44 (68%) and 36/44 (82%) centres currently use IMRT to treat all patients and selected patients with rectal cancer, respectively. There was general agreement concerning several aspects of the IMRT workflow, including patient positioning, use of intravenous contrast and bladder protocols. Greater variation in practice was identified regarding rectal protocols; use of a boost to primary/nodal disease; target volume delineation; organ at risk delineation and dose constraints and treatment verification. Delineation of individual small bowel loops and daily volumetric treatment verification were considered potentially feasible by most centres. Conclusion This survey identified that IMRT is already used to treat rectal cancer in many UK radiotherapy centres, but there is heterogeneity between centres in its implementation and practice. These results have been a valuable aid in framing the recommendations within the new National Rectal Cancer IMRT Guidance. Highlights • First national UK survey of rectal cancer IMRT use and practice. • Considerable variation identified in IMRT implementation and practice. • Results of survey informed recommendations within new national consensus guideline. |
| Databáze: | OpenAIRE |
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