In patients undergoing pre-operative chemoradiation for rectal adenocarcinoma with clinically positive pelvic sidewall nodes that may not be surgically accessible, do you boost these nodes above 50.4 Gy?

Topics: Radiation Oncology • Gastrointestinal Cancers

If so, what dose do you boost these nodes to?

Answer from: Radiation Oncologist at Academic Institution

I use IMRT with a simultaneous integrated boost to 62.5Gy or 70Gy to lateral pelvic, non-TME nodes that are greater than 5 mm on MRI. I use 70Gy when I can spare the sciatic nerve and the ureter, otherwise 62.5Gy /25 fx (the low pelvis receives 50Gy). I always asked the surgeons if they p...

Comments

Radiation Oncologist at Naval Medical Center San Diego
Would you boost imvolved presacral LNs if they are...

Radiation Oncologist at Memorial Sloan-Kettering Cancer Center
The key thing that you did was ask the surgeon. So...

Radiation Oncologist at Naval Medical Center San Diego
Thanks! I wouldn't have asked the surgeon this imp...

Radiation Oncologist at Rush University Medical Center
Communication with the surgeon is imperative. ...

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