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Myerson RJ, Garofalo MC, El Naqa I, et al. Int J Radiat Oncol Biol Phys. 2009

CTVA: internal iliac, pre-sacral, peri-

rectal

Cranial:

• Bifurcation of the common iliac vessels into external/internal

iliacs

(bony landmark: sacral promontory)

• Recto-sigmoid junction

Anterior:

• 1 cm anterior to the sacrum

• Perirectal fascia

• 1 cm into the bladder

• Pelvic organs

Lateral and posterior:

• Pelvic side-wall muscles or bones

Caudal:

Anal canal + 2 cm around, the anal verge

Anal skin involved + 2 cm beyond

sup

inf