935 / 1068
IMRT (vs 3DCRT)
- Differently from rectal ca.: larger
volumes, more caudal border,
(generally) higher doses, (always)
concomitant to CHT, more complex
shape, more concavity of PTV
- 3DCRT: very large incidence of severe
acute tox (mainly skin, GI,
hematological) and treatment breaks
- In the early 2000, several planning
studies demonstrated a large gain of
(sub-optimal*) IMRT vs 3DCRT
(Moran 2004, Chen 2005, Milano
2005, Menkarios 2007)
- Largest sparing for genitals and bowel
* Few segments, manual optimization, few
fields, not stressing modulation….
Milano 2005