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    Intensity-modulated radiotherapy for rectal cancer in the UK in 2020

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    Authors
    Hanna, C. R.
    Slevin, F.
    Appelt, A.
    Beavon, M.
    Adams, R.
    Arthur, Claire
    Beasley, M.
    Duffton, A.
    Gilbert, A.
    Gollins, S.
    Harrison, M.
    Hawkins, M. A.
    Laws, K.
    O'Cathail, S.
    Porcu, P.
    Robinson, M.
    Sebag-Montefiore, D.
    Teo, M.
    Teoh, S.
    Muirhead, R.
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    Affiliation
    CRUK Clinical Trials Unit, University of Glasgow, Glasgow, UK; Beatson West of Scotland Cancer Centre, Glasgow, U
    Issue Date
    2021
    
    Metadata
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    Abstract
    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.
    Citation
    Hanna CR, Slevin F, Appelt A, Beavon M, Adams R, Arthur C, et al. Intensity-modulated Radiotherapy for Rectal Cancer in the UK in 2020. Clin Oncol (R Coll Radiol). 2021.
    Journal
    Clinical Oncology
    URI
    http://hdl.handle.net/10541/623722
    DOI
    10.1016/j.clon.2020.12.011
    PubMed ID
    33423883
    Additional Links
    https://dx.doi.org/10.1016/j.clon.2020.12.011
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.clon.2020.12.011
    Scopus Count
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