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IGRT for rectal cancer

- Mesorectum reported to change

in shape (mainly correlated with

bladder motion)

- Main changes in ANT direction

- Larger impact for short-course,

prone position and female pts

- Residual margins difficult to

assess (local deformations, CTV

contouring uncertainty)

- «Optimal» margins often not

clinically feasible

(Dmin>95%/90% pts too strict

criterion? Contouring uncertainty

too high..?)

- Issues concerning the real clinical

impact in neo-adjuv RT(CHT)

Njikamp 2012

Wout With daily correction