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CTV modulation

Presaral

space

Mesorectum

Internal

iliac

nodes

Obturator

nodes

Extrenal

iliac nodes

sphincter

complex

ischiorectal

fossae

cT3 high (above

the peritoneal

reflection)

+

+

+

cT3 mid-low

(below the

peritoneal

reflection)

+

+

+

+

+

(when

sphincter

infiltration)

+

(when direct

tumor

infiltration)

Any cT with

massive positive

internal iliac

nodes

+

+

+

+

+

(when

sphincter

infiltration)

+

(when direct

tumor

infiltration)

Any cT with

massive positive

obturator nodes

nodes

+

+

+

+

+

+

(when

sphincter

infiltration)

+

(when direct

tumor

infiltration)

cT4 with for

anterior pelvic

organ

+

+

+

+

+

+

(when

sphincter

infiltration)

+

(when direct

tumor

infiltration)