Skip to main content

Should We Tailor the Delineation of Pelvic Structures According to Tumor Presentation?

  • Chapter
  • First Online:
Multidisciplinary Management of Rectal Cancer

Abstract

For decades, radiotherapy has played a fundamental role in promoting outcomes in rectal cancer. Preoperative administration of radiotherapy offers advantages compared to postoperative, and it is considered as the standard treatment in locally advanced rectal cancer [1]. Its role in improving local control still remains even after the introduction of total mesorectal excision (TME), as demonstrated in several randomized trials [2–5].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  1. Sauer R1, Becker H, Hohenberger W, Rödel C et al (2004) Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 351(17):1731–1740

    Article  CAS  PubMed  Google Scholar 

  2. Peeters KC, Marijnen CA, Nagtegaal ID et al (2007) Dutch colorectal cancer group the TME trial after a median follow-up of 6 years: increased local control but no survival benefit in irradiated patients with resectable rectal carcinoma. Ann Surg 246:693–701

    Article  PubMed  Google Scholar 

  3. Sebag-Montefiore D, Stephens RJ, Steele R et al (2009) Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomized trial. Lancet 373:811–820

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bosset JF, Collette L, Calais G et al (2007) Chemotherapy with preoperative radiotherapy in rectal cancer. New Engl J Med 355:1114–1123

    Article  Google Scholar 

  5. Gerard JP, Conroy T, Bonnetain F et al (2006) Radiotherapy with or without concurrent fluorouracil and leucovorin in T3-4 rectal cancers: results of FFCD 9203. J Clin Oncol 24:4620–4625

    Article  PubMed  Google Scholar 

  6. Gunderson LL, Russell AH, Llewellyn HJ et al (1985) Treatment planning for colorectal cancer: radiation and surgical techniques and value of small-bowel films. Int J Radiat Oncol Biol Phys 11:1379–1393

    Article  CAS  PubMed  Google Scholar 

  7. Widder J, Sedlmayer F, Stanek C, Potter R (2000) Quality assurance in preoperative radiotherapy of rectal cancer: evaluation of pre-trial dummy-run. Radiother Oncol 56:341–347

    Article  CAS  PubMed  Google Scholar 

  8. Nijkamp J, de Haas-Kock DFM (2012) Beukema, et al. target volume delineation variation in radiotherapy for early stage rectal cancer in the Netherlands. Radiother Oncol 102(1):14–21

    Article  PubMed  Google Scholar 

  9. Fuller CD, Nijkamp J, Duppen JC et al (2010) Prospective randomized double-blind pilot study of site-specific consensus atlas implementation for rectal cancer target volume delineation in the cooperative group setting. Int J Radiat Oncol Biol Phys 79:481–489

    Article  PubMed  PubMed Central  Google Scholar 

  10. Ng M, Leong T, Chander S et al (2012) Australasian gastrointestinal trials group (AGITG) contouring atlas and planning guidelines for intensity-modulated radiotherapy in anal cancer. Int J Radiat Oncol Biol Phys 83(5):1455–1462

    Article  PubMed  Google Scholar 

  11. Roels S, Duthoy W, Haustermans K et al (2006) Definition and delineation of the clinical target volume for rectal cancer. Int J Radiat Oncol Biol Phys 65:1129–1142

    Article  PubMed  Google Scholar 

  12. Myerson RJ, Garofalo MC, El Naqa I et al (2009) Elective clinical target volumes for conformal therapy in anorectal cancer: a radiation therapy oncology group consensus panel contouring atlas. Int J Radiat Oncol Biol Phys 74:824–830

    Article  PubMed  Google Scholar 

  13. Arcangeli S, Valentini V, Nori SL et al (2003) Underlying anatomy for CTV contouring and lymphatic drainage in rectal cancer radiation therapy. Rays 28(3):331–336

    PubMed  Google Scholar 

  14. Langelé BG (2003) Clinical target volume in conformal and intensity modulated radiation therapy. A clinical guide to cancer treatment. In: Grégoire V, Scalliet P, Ang KK (eds) The lymphatic system, 1st edn. Springer, Heidelberg, pp 23–31

    Google Scholar 

  15. Kusters M, Marijnen CAM, van de Velde CJH (2010) Patterns of local recurrence in rectal cancer; a study of the Dutch TME trial. Eur J Surg Oncol 36:470–476

    Article  CAS  PubMed  Google Scholar 

  16. Kusters M, Wallner C, Lange MM et al (2010) Origin of presacral recurrence after rectal cancer treatment. Br J Surg 97:1582–1588

    Article  CAS  PubMed  Google Scholar 

  17. Heald RJ, Husband EM, Ryall RD (1982) The mesorectum in rectal cancer surgery – the clue for pelvic recurrence? Br J Surg 69:613–616

    Article  CAS  PubMed  Google Scholar 

  18. Syk E, Torkzad MR, Blomqvist L et al (2008) Local recurrence in rectal cancer: anatomic localization and effect on radiation target. Int J Radiat Oncol Biol Phys 72:658–664

    Article  PubMed  Google Scholar 

  19. Nagtegaal ID, Quirke P (2008) What is the role for the circumferential margin in the modern treatment of rectal cancer? J Clin Oncol 26:303–312

    Article  PubMed  Google Scholar 

  20. Bujko K, Nowacki MP, Nasierowska-Guttmejer A et al (2006) Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer. Br J Surg 93(10):1215–1223

    Article  CAS  PubMed  Google Scholar 

  21. MERCURY Study GroupDiagnostic accuracy of preoperative magnetic resonance imaging in predicting curative resection of rectal cancer, prospective observational study. BMJ 333(7272):779

    Google Scholar 

  22. Hruby G, Barton M, Miles S et al (2003) Sites of local recurrence after surgery, with or without chemotherapy, for rectal cancer: implications for radiotherapy field design. Int J Radiat Oncol Biol Phys 55:138–143

    Article  PubMed  Google Scholar 

  23. Nijkamp J, Kusters M, Beets-Tan R et al (2011) Three-dimensional analysis of recurrences patterns in rectal cancer: the cranial border in the hypofractionated preoperative radiotherapy can be lowered. Int J Radiat Oncol Biol Phys 80(1):103–110

    Article  PubMed  Google Scholar 

  24. Sato H, Maeda K, Maruta M et al (2006) Who can get the beneficial effect from lateral lymph node dissection for Dukes C rectal carcinoma below the peritoneal reflection? Dis Colon Rectum 49(10 Suppl):S3–12

    Article  CAS  PubMed  Google Scholar 

  25. Koda K, Saito N, Oda K, Takiguchi N et al (2004) Evaluation of lateral lymph node dissection with preoperative chemo-radiotherapy for the treatment of advanced middle to lower rectal cancers. Int J Color Dis 19:188–194

    Article  CAS  Google Scholar 

  26. Ueno H, Mochizuki H, Hashiguchi Y et al (2007) Potential prognostic benefit of lateral pelvic node dissection for rectal cancer located below the peritoneal reflection. Ann Surg 245:80–87

    Article  PubMed  PubMed Central  Google Scholar 

  27. Ueno M, Oya M, Azekura K et al (2005) Incidence and prognostic significance of lateral lymph node metastasis in patients with advanced low rectal cancer. Br J Surg 92:756–763

    Article  CAS  PubMed  Google Scholar 

  28. Kim TH, Jeong SY, Choi DH et al (2008) Lateral lymph node metastasis is a major cause of locoregional recurrence in rectal cancer treated with preoperative chemoradiotherapy and curative resection. Ann Surg Oncol 15:729–737

    Article  PubMed  Google Scholar 

  29. Kusters M, van de Velde CJ, Beets-Tan RG et al (2008) Patterns of local recurrence in rectal cancer: a single-center experience. Ann Surg Oncol 16:289–296

    Article  PubMed  PubMed Central  Google Scholar 

  30. Kusters M, Beets GL, van de Velde CJ et al (2009) A comparison between the treatment of low rectal cancer in Japan and the Netherlands, focusing on the patterns of local recurrence. Ann Surg 249:229–235

    Article  PubMed  Google Scholar 

  31. Nagawa H, Muto T, Sunouchi K et al (2001) Randomized, controlled trial of lateral node dissection vs. nerve-preserving resection in patients with rectal cancer after preoperative radiotherapy. Dis Colon Rectum 44:1274–1280

    Article  CAS  PubMed  Google Scholar 

  32. Yu TK, Bhosale PR, Crane CH et al (2008) Patterns of locoregional recurrence after surgery and radiotherapy or chemoradiation for rectal cancer. Int J Radiat Oncol Biol Phys 71:1175–1180

    Article  PubMed  Google Scholar 

  33. Mangan CE, Rubin SC, Ds R et al (1986) Lymphnode nomenclature in the gynecologic oncology. Gynecol Oncol 23:222–226

    Article  CAS  PubMed  Google Scholar 

  34. Steup WH, Moriya Y, van de Velde CJH (2002) Patterns of lymphatic spread in rectal cancer. A topographical analysis on lymph node metastases. Eur J Cancer 38:911–918

    Article  CAS  PubMed  Google Scholar 

  35. Koh DM, Chau I, Tait D et al (2008) Evaluating mesorectal lymph nodes in rectal cancer before and after neoadjuvant. Int J Radiat Oncol Biol Phys 71:456–461

    Article  PubMed  Google Scholar 

  36. Bujko K, Bujko M, Pietrzak L (2007) Clinical target volume for rectal cancer: in regard to Roels et al. (Int J Radiat Oncol Biol Phys 2006;65:1129–1142). Int J Radiat Oncol Biol Phys 68:313

    Article  PubMed  Google Scholar 

  37. Joye I, Haustermans K (2015) Clinical target volume delineation for rectal cancer radiation therapy: time for updated guidelines? Int J Radiat Oncol Biol Phys 91(4):690–691

    Article  PubMed  Google Scholar 

  38. Taylor A, Rockall AG, Powell ME (2007) An atlas of the pelvic lymph node regions to aid radio- therapy target volume definition. Clin Oncol (R Coll Radiol) 19:542–550

    Article  CAS  Google Scholar 

  39. Ippolito E, Mertens I, Haustermans K et al (2008) IGRT in rectal cancer. Acta Oncol 47:1317–1324

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Maria Antonietta Gambacorta .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer-Verlag Berlin Heidelberg

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Gambacorta, M.A., Chiloiro, G., Valentini, V. (2018). Should We Tailor the Delineation of Pelvic Structures According to Tumor Presentation?. In: Valentini, V., Schmoll, HJ., van de Velde, C. (eds) Multidisciplinary Management of Rectal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-43217-5_21

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-43217-5_21

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43215-1

  • Online ISBN: 978-3-319-43217-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics