Intensity-modulated radiotherapy for rectal cancer in the UK in 2020
AuthorsHanna, C. R.
Hawkins, M. A.
AffiliationCRUK Clinical Trials Unit, University of Glasgow, Glasgow, UK; Beatson West of Scotland Cancer Centre, Glasgow, U
MetadataShow full item record
AbstractAims: 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.
CitationHanna 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.
- Initial Results from the Royal College of Radiologists' UK National Audit of Anal Cancer Radiotherapy 2015.
- Authors: Muirhead R, Drinkwater K, O'Cathail SM, Adams R, Glynne-Jones R, Harrison M, Hawkins MA, Sebag-Montefiore D, Gilbert DC
- Issue date: 2017 Mar
- Clinical impact of IMPORT HIGH trial (CRUK/06/003) on breast radiotherapy practices in the United Kingdom.
- Authors: Tsang Y, Ciurlionis L, Kirby AM, Locke I, Venables K, Yarnold JR, Titley J, Bliss J, Coles CE, IMPORT Trial Management Group.
- Issue date: 2015
- Changes in Patterns of Intensity-modulated Radiotherapy Verification and Quality Assurance in the UK.
- Authors: Abolaban F, Zaman S, Cashmore J, Nisbet A, Clark CH
- Issue date: 2016 Aug
- Treatment Volume, Dose Prescription and Delivery Techniques for Dose-intensification in Rectal Cancer: A National Survey.
- Authors: Caravatta L, Lupattelli M, Mantello G, Gambacorta MA, Chiloiro G, DI Tommaso M, Rosa C, Gasparini L, Morganti AG, Picardi V, Niespolo RM, Osti MF, Montrone S, Simoni N, Boso C, Facchin F, Deidda MA, Piva C, Guida C, Ziccarelli L, Munoz F, Ivaldi GB, Marchetti V, Franzone P, Spatola C, Franco P, Donato V, Genovesi D, Gastrointestinal Study Group of AIRO (Italian Association of Radiation Oncology and Clinical Oncology).
- Issue date: 2021 Apr
- A Dosimetric Analysis of Preoperative Intensity-modulated and Image-guided Radiation Therapy with and without Simultaneous Integrated Boost for Locally Advanced Rectal Cancer.
- Authors: Yang Y, Feng L, Wang Y, Ge R, Gong H, Xie C, Wang J, Chen J, Lan Y, Ma L
- Issue date: 2015 Oct