Would you consider long course pelvic CRT after neoadjuvant chemotherapy in a patient with low lying, locally advanced rectal adenocarcinoma when you're unable to meet small bowel constraints?

Unable to meet small bowel constraints due to bowel falling in the field; posterior to the rectum and anterior to the sacrum. V15 is 300 cc and lowering overall dose to 41.4/23 did not change the parameter.

Answer from: Radiation Oncologist at Academic Institution

I would definitely offer long course chemoradiation in this setting. The V15 small bowel is not a constraint that should be used to determine treatment. The only absolute constraint I use for pelvic chemoradiation for rectal cancer is a small bowel maximum dose of 55 Gy. The 55 Gy maximum dose const...

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Would you consider long course pelvic CRT after neoadjuvant chemotherapy in a patient with low lying, locally advanced rectal adenocarcinoma when you're unable to meet small bowel constraints?

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