Anal and Rectal Cancers - ASTRO

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Outline • Pelvic Anatomy and Nodal Drainage Patterns • Contouring and planning recommendations for IMRT in the treatment of Anal Cancer • IMRT in Rectal Cancer • IGRT and motion issues in the treatment of pelvic tumors
644 Anal SCC Patients 5-Year Rates Disease Disease-free free Survival Local Relapse Colostomy Distant Mets. Overall Survival RTOG 98 98-11 11 RT + MMC/5-FU Cis/5-FU RT + Cis/5-FU C/F�RT C/F�RT+C/F C/F RT RT+MMC/F MMC/F (%) (%) p Ajani JA et al., JAMA 2008;299:1941-1921
Page 1 and 2: Anal and Rectal Cancers: Anatomy, C
Page 3 and 4: Learning Objectives Objectives •
Page 5 and 6: Anatomy of the Rectum and Anus Meso
Page 7 and 8: Nodal Drainage Patterns
Page 9 and 10: Nodal Anatomy External Iliac Nodes
Page 11: Nodal Anatomy
Page 17 and 18: • AP/PA - RTOG RT Technique - 30
Page 19 and 20: 180 patients 45 locoregional persis
Page 21 and 22: RTOG 0529: Dose Painted IMRT in Ana
Page 23 and 24: CTV A includes: • MMesorectallnod
Page 25 and 26: Ng M, Int J Radiat Oncol Biol Phys,
Page 27 and 28: Ng M, Int J Radiat Oncol Biol Phys,
Page 29 and 30: IMRT plan for Anal Cancer
Page 31 and 32: IMRT for Anal Cancer • 17 patient
Page 33 and 34: Multicenter Experience • 53 patie
Page 35 and 36: Potential Limitations of IMRT • H
Page 37 and 38: Simulation Set-up Set up CT Simulat
Page 39 and 40: Preoperative 5FU +5040cGy pelvic RT
Page 41 and 42: Dosimetric Benefit of IMRT for Rect
Page 43 and 44: Rectal Cancer - Target Definition
Page 45 and 46: IMRT v. CRT • 92 rectal cancer pt
Page 47 and 48: Indications for IMRT for Rectal Can
Page 49 and 50: Rectal Cancer - Radiation Technique
Page 51 and 52: IGRT and Motion Issues • Improvem
Page 53 and 54: Rectal MRI Mercury Study group, Bri
Page 55 and 56: MRI to Risk Stratify Rectal Cancer
Page 57 and 58: MRI as a Biomarker • Regression o
Page 59: PET for Treatment Planning
Page 62 and 63:
Impact of PET on RT Planning Patel,
Page 64 and 65:
Rectal Tumor Motion • IMRT for re
Page 66 and 67:
Serial CT Scans Max RL Mean RL Max
Page 68 and 69:
Recommendations for IGRT for Pelvic
Page 70:
Thank you
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Anal and Rectal Cancers - ASTRO

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