Arp, D.T. orcid.org/0009-0007-7980-5539, Appelt, A.L. orcid.org/0000-0003-2792-9218, Jensen, L.H. et al. (6 more authors) (2024) Treatment planning for patients with low rectal cancer in a multicenter prospective organ preservation study. Physica Medica, 118. 103206. ISSN 1120-1797
Abstract
Background Non-surgical management of rectal cancer relies on (chemo)radiotherapy as the definitive treatment modality. This study reports and evaluates the clinical high dose radiotherapy treatment plans delivered to patients with low resectable rectal cancer in a Danish multicenter trial.
Methods The Danish prospective multicenter phase II Watchful Waiting 2 trial (NCT02438839) investigated definitive chemoradiation for non-surgical management of low rectal cancer. Three Danish centers participated in the trial and committed to protocol-specified treatment planning and delivery requirements. The protocol specified a dose of 50.4 Gy in 28 fractions to the elective volume (CTV-/PTV-E) and a concomitant boost of 62 Gy in 28 fractions to the primary target volume (CTV-/PTV-T).
Results The trial included 108 patients, of which 106 treatment plans were available for retrospective analysis. Dose coverage planning goals for the main target structures were fulfilled for 94% of the treatment plans. However, large intercenter differences in doses to organs-at-risk (OARs) were seen, especially for the intestines. Five patients had a V60Gy>10 cm3 for the intestines and two patients for the bladder.
Conclusion Prescribed planning goals for target coverage were fulfilled for 94% of the treatment plans, however analysis of OAR doses and volumes indicated intercenter variations. Dose escalation to 62 Gy (as a concomitant boost to the primary tumor) introduced no substantial high dose volumes (>60 Gy) to the bladder and intestines. The treatment planning goals may be used for future prospective evaluation of highdose radiotherapy for organ preservation for low rectal cancer.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2024 Associazione Italiana di Fisica Medica e Sanitaria. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
Keywords: | Multicenter; Organ preservation; Radiotherapy Treatment Planning; Rectal cancer |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Medical Research (LIMR) > Division of Oncology |
Funding Information: | Funder Grant number Cancer Research UK Supplier No: 138573 A28832 Yorkshire Cancer Research Account Ref: 2UOLEEDS Not Known |
Depositing User: | Symplectic Publications |
Date Deposited: | 25 Jan 2024 11:46 |
Last Modified: | 25 Jan 2024 11:46 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.ejmp.2023.103206 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:208223 |