Anal and Rectal Cancers - ASTRO

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RTOG 0822 • Primary endpoint: Comparison of Grade 2+ GI toxicity i i to RTOG 0247 ( (non-IMRT) IMRT) • 68 analyzable patients • 90% T3, 55% N+ • 51% Grade 2+ GI toxicity compared to 58% on RTOG 0247 (NS) • Only 5 (7%) had unacceptable CTV Garafalo MM, <strong>ASTRO</strong> 2011
IMRT v. CRT • 92 rectal cancer pts treated from 2004-2009 • 61 – CRT CRT, 31 – IMRT • 45/50.4 Gy for CRT • 45/50 Gy for IMRT using an integrated boost Samuelian JM JM, IJROBP IJROBP, 2012
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 15 and 16: 644 Anal SCC Patients 5-Year Rates
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: Rectal Cancer - Target Definition
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

Anal and Rectal Cancers - ASTRO

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