The role of external beam and endoluminal radiation boosting in rectal cancer

[...]in order to limit the risk of rectal toxicity in rectal boosting, the volume of healthy tissue exposed to the boost dose should be as small as possible. [...]the more selective the technique, the higher the radiation doses that can be applied to the tumor with an isotoxic effect, and the higher...

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Bibliographic Details
Published in:Colorectal cancer 2019-03, Vol.8 (1)
Main Authors: Berbée, Maaike, Verrijssen, An-Sofie, Buijsen, Jeroen, Verhaegen, Frank, Van Limbergen, Evert Jan
Format: Article
Language:English
Subjects:
Advantages
boost
brachytherapy
Cancer therapies
Colorectal cancer
dose escalation
Radiation therapy
radiotherapy
rectal cancer
Surgery
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Summary:[...]in order to limit the risk of rectal toxicity in rectal boosting, the volume of healthy tissue exposed to the boost dose should be as small as possible. [...]the more selective the technique, the higher the radiation doses that can be applied to the tumor with an isotoxic effect, and the higher the expected CR rate. [...]as the tumor is being irradiated from the outside as opposed to from a short distance as in endoluminal techniques, external beam boosting is probably the least selective technique by nature. [...]treatment selectivity might be negatively affected by tumor movement due to changes in rectal and bladder filling and by poor visibility of the tumor on standard set-up imaging modalities such as cone beam CT. [...]the clinical results of external beam based rectal dose escalation have not been truly convincing (5-12). [...]consensus guidelines on dose reporting and treatment volume specification should be implemented as soon as possible.
ISSN:1758-194X
1758-1958
DOI:10.2217/crc-2019-0006