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Updated: Mar 16, 2026
Stereotactic Radiosurgery for Gynecologic Cancer
Published on: April 17, 2012
International consensus guidelines on Clinical Target Volume delineation in rectal cancer
Vincenzo Valentini1, Maria Antonietta Gambacorta1, Brunella Barbaro2
1Università Cattolica del Sacro Cuore, Radiation Oncology Department, Rome, Italy.
Introduction:
The delineation of Clinical Target Volume (CTV) is a critical step in radiotherapy. Several guidelines suggest different subvolumes and anatomical boundaries in rectal cancer (RC), potentially leading to a misunderstanding in the CTV definition. International consensus guidelines (CG) are needed to improve uniformity in RC CTV delineation.
Material And Methods:
The 7 radiation oncologist experts defined a roadmap to produce RC CG. Step 1: revision of the published guidelines. Step 2: selection of RC cases with different clinical stages. Step 3: delineation of cases using Falcon following previously published guidelines. Step 4: meeting in person to discuss the initial delineation outcome, followed by a CTV proposal based on revised and if needed, adapted anatomical boundaries. Step 5: peer review of the agreed consensus. Step 6: peer review meeting to validate the final outcome. Step 7: completion of RC delineation atlases.
Results:
A new ontology of structure sets was defined and the related table of anatomical boundaries was generated. The major modifications were about the lateral lymph nodes and the ischio-rectal fossa delineation. Seven RC cases were made available online as consultation atlases.
Conclusion:
The definition of international CG for RC delineation endorsed by international experts might support a future homogeneous comparison between clinical trial outcomes.
