Radiation Oncology/Rectum/Guidelines

Rectal Cancer Official Guidelines

Screening

• ACS: Colorectal Cancer: Early Detection
  • Guideline link
• Joint Consensus Guideline: Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps
  • From ACS, ACR, and US Multi-Society Task Force
  • 2008 Guideline link PMID 18384785

Tumor Markers

• ASCO: Use of Tumor Markers in GI Malignancies
  • 2006 Guideline link PMID 17060676 -- "ASCO 2006 update of recommendations for the use of tumor markers in gastrointestinal cancer." (Locker GY, J Clin Oncol. 2006 Nov 20;24(33):5313-27.)

Treatment

• ACR: Local Excision in Early Stage Rectal Cancer
  • Guideline link

• ACR: Rectal Cancer—Metastatic Disease at Presentation
  • Guideline link

• ACR: Recurrent Rectal Cancer
  • Guideline link

• ACR: Resectable Rectal Cancer
  • Guideline link

Contouring Guidelines

• RTOG Atlas
  • RTOG Anorectal Contouring Guidelines
  • 2009 PMID 19117696 -- "Elective clinical target volumes for conformal therapy in anorectal cancer: a radiation therapy oncology group consensus panel contouring atlas." (Myerson RJ, Int J Radiat Oncol Biol Phys. 2009 Jul 1;74(3):824-30. Epub 2008 Dec 29.)
  • 2011 PMID 20400244 -- "Prospective randomized double-blind pilot study of site-specific consensus atlas implementation for rectal cancer target volume delineation in the cooperative group setting." (Fuller CD, Int J Radiat Oncol Biol Phys. 2011 Feb 1;79(2):481-9. Epub 2010 Apr 18.)
    • Randomized. 1 rectal case, 14 physicians and one reference expert countouring. Arm 1) consensus guideline vs Arm 2) no consensus guideline. Two contours, pre- and post.
    • Outcome: Greater agreement for GTV (0.75) than for CTVs (0.46 - 0.65). For consensus guideline group, only improvement after reviewing atlas was for CTVA, no impact on GTV and CTVB contours
    • Conclusion: Visual atlas inclusion should be considered in clinical trials