Adaptive radiation dose escalation in rectal adenocarcinoma: a review. J Gastrointest Oncol 2017 Oct;8(5):902-914
Date
12/01/2017Pubmed ID
29184696Pubmed Central ID
PMC5674246DOI
10.21037/jgo.2017.07.06Scopus ID
2-s2.0-85031666657 (requires institutional sign-in at Scopus site) 18 CitationsAbstract
Total mesorectal excision (TME) after neoadjuvant chemoradiotherapy (CRT) has offered superior control for patients with locally advanced rectal cancer, but can carry a quality of life cost. Fortunately, some patients achieve a complete response after CRT alone without the added morbidity caused by surgery. Efforts to increase fidelity of radiation treatment planning and delivery may allow for escalated doses of radiotherapy (RT) with limited off-target toxicity and elicit more pathological complete responses (pCR) to CRT thereby sparing more rectal cancer patients from surgery. In this review, methods of delivering escalated RT boost above 45-50.4 Gy are discussed including: 3D conformal, intensity-modulated radiotherapy (IMRT), and brachytherapy. Newly developed adaptive boost strategies and imaging modalities used in RT planning and response evaluation such as magnetic resonance imaging (MRI) and positron emission tomography (PET) are also discussed.
Author List
Van Wickle JD, Paulson ES, Landry JC, Erickson BA, Hall WAAuthors
Beth A. Erickson MD Professor in the Radiation Oncology department at Medical College of WisconsinWilliam Adrian Hall MD Professor in the Radiation Oncology department at Medical College of Wisconsin
Eric Paulson PhD Chief, Professor in the Radiation Oncology department at Medical College of Wisconsin
