A practice survey of the evolution of rectal cancer management: a Belgian Federal College of radiotherapy study.
The aim of the present study was to perform a rectal cancer practice survey in order to re-assess in 2005 the Belgian state of the art. A questionnaire based on the past 1999 peer review, supplemented with general questions, was circulated to 16 radiotherapy centres in Belgium. A case was also proposed for treatment planification. In 2005, a formal multidisciplinary team was in place in all visited centres. Endorectal ultrasound, colonoscopy, CEA and an initial pathological diagnosis were standard procedure in all centres. For T1-2N0, the majority of centres do not perform a preoperative treatment; for T3N0, a majority proposes a preoperative radiochemotherapy. For all T3-4 any N, or any T-N involved, a neoadjuvant preoperative treatment is prescribed. Fractionation is conventional (1.8 Gy/d, five times a week). Analysing the practical case, the mean value for CTV and PTV volume was 393 (SD: 126) and 781 cm3 (SD: 105), respectively. Mean D(min) and D(max) of 92 and 106.5%, respectively, were measured in the PTV. From clinical point of view, standards concepts are emerging and spreading for staging and for treatment options. Nevertheless, there is still a need for standardization of volumes and delineation standards.
Magné
Nicolas
N
Department of Radio-Oncology, Institut-Jules-Bordet, Bruxelles, Belgium. nicolas.magne@igr.fr
Daisne
Jean-François
JF
Moretti
Luigi
L
Berben
Dorothée
D
Meert
Nicolas
N
Alen
Ruth
R
Bral
Samuel
S
Cleef
Ann Van
AV
Haustermans
Karin
K
Houtte
Paul Van
PV
Scalliet
Pierre
P
D000970:Antineoplastic Agents / Q000627:therapeutic use; D001530:Belgium; D003131:Combined Modality Therapy; D019538:Health Care Surveys; D006801:Humans; D009367:Neoplasm Staging / Q000379:methods; D018024:Peer Review, Health Care; D018787:Radiation Oncology / Q000639:trends*; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D011795:Surveys and Questionnaires; D047368:Tumor Burden
D000970:Antineoplastic Agents