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?

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...