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- W2908927710 abstract "There are no guidelines on clinical target volume (CTV) delineation for cT2 rectal cancer treated with organ preservation.A systematic review and meta-analysis were performed to determine the extent of distal mesorectal (DMS) and distal intramural spread (DIS), the risk of lateral lymph node (LLN) metastases in pT2 tumours, and regional recurrence pattern after organ preservation.The rate of DMS > 1 cm was 1.9% (95% CI: 0.4-5.4%), maximum extent: 1.3 cm. The rate of DIS > 0.5 cm was 4.7% (95% CI: 1.3-11.5%), maximum extent: 0.8 cm. The rate of LLN metastases was 8.2% (95% CI: 6.7-9.9%) for tumours below or at peritoneal reflexion and 0% for higher tumours. Regional nodal recurrences alone were recorded in 1.0% (95% CI: 0.5-1.7%) of patients after watch-and-wait and in 2.1% (95% CI: 1.2-3.4%) after preoperative radiotherapy and local excision. Thus, the following rules for CTV delineation are proposed: caudal border 1.5 cm from the tumour to account for DMS or 1 cm to account for DIS, whichever is more caudal; cranial border at S2/S3 interspace; inclusion of LLN for tumours at or below peritoneal reflexion. A planning study was performed in eight patients to compare dose-volume parameters obtained using these rules to that obtained using current guidelines for advanced cancers. The proposed rules led to a mean 18% relative reduction of planning target volume, which resulted in better sparing of organs-at-risk.This meta-analysis suggests a smaller CTV for cT2 tumours than the current guidelines designed for advanced cancers." @default.
- W2908927710 created "2019-01-25" @default.
- W2908927710 creator A5010751837 @default.
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- W2908927710 creator A5050801485 @default.
- W2908927710 creator A5055517658 @default.
- W2908927710 creator A5057500507 @default.
- W2908927710 date "2019-04-01" @default.
- W2908927710 modified "2023-10-01" @default.
- W2908927710 title "A systematic review and meta-analysis of pT2 rectal cancer spread and recurrence pattern: Implications for target design in radiation therapy for organ preservation" @default.
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