When treating early stage rectal cancer (T1-2N0) with neoadjuvant long course CRT with the goal of downstaging for sphincter preserving surgery, do you reduce your radiation volumes to spare toxicity?

For example, not placing superior border at L5/S1.

Answer from: Radiation Oncologist at Academic Institution

Trans anal excision should be feasible for T1N0 without preop RX. Preop chemoRT plus trans anal excision should be suitable for T2N0. Would not recommend long course induction chemotherapy.

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When treating early stage rectal cancer (T1-2N0) with neoadjuvant long course CRT with the goal of downstaging for sphincter preserving surgery, do you reduce your radiation volumes to spare toxicity?

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