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Improving IMRT in anal cancer: skin tox
- Rotational technique may help
(better conformality)
- Explicit inclusion of
constrained «skin region» &
PTV corrections near the
skin….(be careful…)
- Role of IGRT
- Impact of bolus
- Inguinal nodes vs no inguinal
node (role of sentinel
lymphonode, PET imaging…)
Joseph 2015 «….
PTV45 volumes were limited to 3–5 mm from the
skin surface. Bolus was used for 4 patients with perianal extension.»