title: Advances in radiotherapy delivery for rectal cancer: a European perspective.
abstract: Preoperative chemoradiotherapy and radiotherapy with an integrated boost offer excellent local control rates in patients with rectal cancer. The introduction of intensity-modulated radiotherapy and image-guided radiotherapy has drastically improved the tolerance of these treatments. The new challenge is developing organ-preserving strategies and curative treatments for medically inoperable patients. Contact radiotherapy seems efficient for small tumors. Tumor hypoxia limits the success of radiotherapy for locally advanced cancers. Modulation of the L-arginine/iNOS pathway and implementation of hypoxia imaging in radiotherapy planning may overcome this hurdle.
authors: Department of Gastroenterology, UZ Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussel, Belgium.
authors: Alexandra
authors: A
authors: Sermeus
authors: Benedikt
authors: B
authors: Engels
authors: Daniel
authors: D
authors: Urbain
authors: Mark
authors: M
authors: De Ridder
mesh_terms: D000818:Animals; D059186:Chemoradiotherapy, Adjuvant; D003695:Delivery of Health Care; D003952:Diagnostic Imaging / Q000379:methods; D005060:Europe; D006801:Humans; D020360:Neoadjuvant Therapy / Q000009:adverse effects / Q000379:methods*; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D012307:Risk Factors; D016896:Treatment Outcome
keywords: image-guided radiotherapy; image-modulated radiotherapy; preoperative radiotherapy; rectal cancer; tumor hypoxia