What target volumes do you use for rectosigmoid/very superior rectal cancers?

Does it ever differ from a standard rectal field? For example, do you always treat the entire rectum, mesorectum, and entire length of internal iliac vessels (i.e. down to obturator foramen for 3D plans) in your initial field?

Answer from: Radiation Oncologist at Academic Institution

The simple answer is that there should be a major alteration in treatment volumes in these patients, as there should be NO target volume as most of these patients with very high rectal/rectosigmoid tumors do not need to be irradiated at all. If one looks at failure patterns, the risk of local failur...

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Radiation Oncologist at Berkshire Medical Center
So what is the recommended target volume to cover ...

Radiation Oncologist at Colorado Permanente Medical Group
How do you define "high rectum", with respect to a...

Radiation Oncologist at Cook Radiation Oncology
The RAPIDO protocol allows for only 4 cm of mesore...

Answer from: Radiation Oncologist at Academic Institution

I agree with @Joel E. Tepper's answer. The one case where we usually treat in this context is very long tumors where the tumor is above and below the peritoneal reflection. I ask the surgeon if a mesorectal dissection will be performed, and, if so, I think it is reasonable to treat the mesorectum. I...

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Radiation Oncologist at CCare
It sounds like in that case, you treat the mesorec...

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What target volumes do you use for rectosigmoid/very superior rectal cancers?

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