Top

Published in:

01-08-2017 | Radiation Therapy and Radiation Therapy Innovations in Colorectal Cancer (JY Wo, Section Editor)

Clinical Target Volume Definition in Preoperative Radiotherapy of Rectal Carcinoma: a Systematic Review

Authors: Marianna Nuzzo, Amalia Bisceglia, Milena Giordano, Lucia Giaccherini, Alessandra Guido, Gabriella Macchia, Annamaria Vinciguerra, Giovanna Mantello, Giuseppina Sallustio, Savino Cilla, Silvia Cammelli, Francesco Deodato, Milly Buwenge, Domenico Genovesi, Lorenzo Fuccio, Alessio G. Morganti

Published in: Current Colorectal Cancer Reports | Issue 4/2017

Abstract

Purpose of Review

Preoperative radiotherapy (RT) or chemoradiation represents a standard option in neoadjuvant treatment of rectal cancer (RC). The aim of this analysis is to present a systematic review of clinical target volume (CTV) definition in preoperative RT of RC.

A systematic review of published literature was performed. Studies providing clear indications for CTV definition in preoperative RT of RC were eligible. Only studies published as full text were considered. The search was restricted to English, German, and French languages. The CTV delineation, based on the different guidelines, was drawn on selected slices of a CT scan and the CTV definition based on different guidelines was reported in a table to facilitate the comparison.

Recent Findings

A total of six publications containing indications for CTV delineation fulfilled the selection criteria and were included in our review. The studies showed a large variability in available indications between CTV contouring guidelines of RC, partly arising from differences in methods used to propose the single guidelines: expert opinion, systematic review, computer-generated consensus, and 3D modeling of recurrence sites.

Summary

In our systematic analysis, the available indications for CTV definition in preoperative RT of RC were reviewed. A large variation in target volume delineation was observed.

Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63:11–30. doi:10.3322/caac.21166.CrossRefPubMed

Bujko K, Nowacki MP, Nasierowska-Guttmejer A, et al. Sphincter preservation following pre-operative radiotherapy for rectal cancer: report of randomized trial comparing short-term radiotherapy versus conventionally fractionated radiochemotherapy. Radiother Oncol. 2004;72:15–24. doi:10.1016/j.radonc.2003.12.006.CrossRefPubMed

Valentini V, Beets-Tan R, Borras JM, et al. Evidence and research in rectal cancer. Radiother Oncol. 2008;87:449–74. doi:10.1016/j.radonc.2008.05.022.CrossRefPubMed

Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004;351:1731–40. doi:10.1056/NEJMoa040694.CrossRefPubMed

Sebag-Montefiore D, Stephens RJ, Steele R, et al. Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial. Lancet. 2009;373:811–20. doi:10.1016/S0140-6736(09)60484-0.CrossRefPubMedPubMedCentral

Frykholm GJ, Glimelius B, Påhlman L. Preoperative or postoperative irradiation in adenocarcinoma of the rectum: final treatment results of a randomized trial and an evaluation of late secondary effects. Dis Colon Rectum. 1993;36:564–72. doi:10.1007/BF02049863.CrossRefPubMed

Nijkamp J, de Haas-Kock DF, Beukema JC, et al. Target volume delineation variation in radiotherapy for early stage rectal cancer in the Netherlands. Radiother Oncol. 2012;102:14–21. doi:10.1016/j.radonc.2011.08.011.CrossRefPubMed

Lobefalo F, Bignardi M, Reggiori G, et al. Dosimetric impact of inter-observer variability for 3D conformal radiotherapy and volumetric modulated arc therapy: the rectal tumor target definition case. Radiat Oncol. 2013;8:176. doi:10.1186/1748-717X-8-176.CrossRefPubMedPubMedCentral

Fuller CD, Nijkamp J, Duppen JC, et al. Radiation oncology Committee of the Southwest Oncology Group. 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. 2011;79:481–9. doi:10.1016/j.ijrobp.2009.11.012.CrossRefPubMed

10.

Gambacorta MA, Valentini C, Dinapoli N, et al. Clinical validation of atlas-based auto-segmentation of pelvic volumes and normal tissue in rectal tumors using auto-segmentation computed system. Acta Oncol. 2013;52:1676–81. doi:10.3109/0284186X.2012.75498.CrossRefPubMed

11.

Lorchel F, Maingon P, Crehange G, Bosset M, Bosset JF. Cancer du rectum: volumes cibles de la radiothérapie préopératoire. Cancer Radiother, 2002; Suppl 1: 93–99.

12.

Myerson RJ, Garofalo MC, El Naqa I, et al. Elective clinical target volumes for conformal therapy in anorectal cancer: a radiation theraphy oncology group consensus panel contouring atlas. Int J Radiat Oncol Biol Phys. 2009;74:824–30. doi:10.1016/j.ijrobp.2008.08.070.CrossRefPubMed

13.

Nijkamp J, Kusters M, Beets-Tan RG, Martijn H, Beets GL, van de Velde CJ, et al. Three-dimensional analysis of recurrence patterns in rectal cancer: the cranial border in hypofractionated preoperative radiotherapy can be lowered. Int J Radiat Oncol Biol Phys. 2011;80:103–10. doi:10.1016/j.ijrobp.2010.01.046.CrossRefPubMed

14.

Roels S, Duthoy W, Haustermans K, Penninckx F, Vincent V, Boterberg T, et al. Definition and delineation of the clinical target volume for rectal cancer. Int J Radiat Oncol Biol Phys. 2006;65:1129–42. doi:10.1016/j.ijrobp.2006.02.050.CrossRefPubMed

15.

• Valentini V, Gambacorta MA, Barbaro B, Chiloiro G, Coco C, Das P, et al. International consensus guidelines on clinical target volume delineation in rectal cancer. Radiother Oncol. 2016;120:195–201. doi:10.1016/j.radonc.2016.07.017. Recent guidelines, endorsed by international experts, on CTV delineation in rectal cancer to reduce the variations in target volume interpretation and decrease the inter-observer variability CrossRefPubMed

16.

Moher D, Shamseer L, Clarke M, et al. PRISMA-P Group. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4:1. doi:10.1186/2046-4053-4-1.CrossRefPubMedPubMedCentral

17.

Morganti AG, Pasquarelli L, Deodato F, et al. Videoconferencing to enhance the integration between clinical medicine and teaching: a feasibility study. Tumori. 2008;94:822–9.PubMed

18.

Taylor A, Rockall AG, Reznek RH, Powell ME. Mapping pelvic lymph nodes: guidelines for delineation in intensity modulated radiotherapy. Int J Radiat Oncol Biol Phys. 2005;63:1604–12. doi:10.1016/j.ijrobp.2005.05.062.

19.

Gwynne S, Mukherjee S, Webster R, et al. Imaging for target volume delineation in rectal cancer radiotherapy—a systematic review. Clin Oncol (R Coll Radiol). 2012;24:52–63. doi:10.1016/j.clon.2011.10.001.CrossRef

20.

Syk E, Torkzad MR, Blomqvist L, et al. Local recurrence in rectal cancer: anatomic localization and effect on radiation target. Int J Radiat Oncol Biol Phys. 2008;72:658–64. doi:10.1016/j.ijrobp.2008.01.063.CrossRefPubMed

21.

• Joye I, Haustermans K. Clinical target volume delineation for rectal cancer radiation therapy: time for updated guidelines? Int J Radiat Oncol Biol Phys. 2015;91:690–1. doi:10.1016/j.ijrobp.2014.11.006. A brief critical review of the literature to introduce new adjustments in the clinical target volume definition for rectal cancer CrossRefPubMed

22.

Bujko K, Bujko M, Pietrzak L. Clinical target volume for rectal carcer in regard to Roels et al. Int J Radiat Oncol Biol Phys. 2007;68:313–6. doi:10.1016/j.ijrobp.2014.11.006.CrossRefPubMed

23.

Caravatta L, Macchia G, Mattiucci GC, et al. Inter-observer variability of clinical target volume delineation in radiotherapy treatment of pancreatic cancer: a multi-institutional contouring experience. Radiat Oncol. 2014;9:198. doi:10.1186/1748-717X-9-198.CrossRefPubMedPubMedCentral

Title: Clinical Target Volume Definition in Preoperative Radiotherapy of Rectal Carcinoma: a Systematic Review
Authors: Marianna Nuzzo
Amalia Bisceglia
Milena Giordano
Lucia Giaccherini
Alessandra Guido
Gabriella Macchia
Annamaria Vinciguerra
Giovanna Mantello
Giuseppina Sallustio
Savino Cilla
Silvia Cammelli
Francesco Deodato
Milly Buwenge
Domenico Genovesi
Lorenzo Fuccio
Alessio G. Morganti
Publication date: 01-08-2017
Publisher: Springer US
Published in: Current Colorectal Cancer Reports / Issue 4/2017
Print ISSN: 1556-3790
Electronic ISSN: 1556-3804
DOI: https://doi.org/10.1007/s11888-017-0375-4

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 4/2017

Biomarkers that Predict Response to Neoadjuvant Chemoradiation in Locally Advanced Rectal Cancer

Colorectal Cancer Surveillance: What Is the Optimal Frequency of Follow-up and Which Tools Best Predict Recurrence?

The Role of CT Colonography as a Screening Tool for Colorectal Cancer

Resistance Mechanisms to Colorectal Cancer Therapeutics and the Clinical Implications

Adenomatous Polyposis Syndromes: Familial Adenomatous Polyposis and MutYH-Associated Polyposis

Quality Colorectal Cancer Screening: Endoscopic Performance Measures and Beyond

Keynote webinar | Spotlight on antibody–drug conjugates in cancer