Appropriate customization of radiation therapy for stage II and III rectal cancer

  • Publication
    Online – November 2015
    Print – May 2016

    This clinical practice statement focuses on clinical scenarios for four treatment settings for stage II and III rectal cancer. First, it addresses appropriate neoadjuvant therapy and how it is impacted by risk classification, distance from distal tumor edge to anal verge and distance from radial tumor edge to edge of mesorectal fascia. Second, the document looks how circumferential resection margin, risk classification, distance from the anal verge and total nodal count effect choice of adjuvant therapy. Third, treatment for medically inoperable patients and the role of performance status, presence of local symptoms and distance from the anal verge is discussed. Finally, the clinical practice statement considers chemoradiation with or without boost in patients who sought to avoid or refused abdominoperineal resection. 

    Read the executive summary
    Read the full guideline

    Quick Reference

    • Neoadjuvant short-course radiation therapy
    • Adjuvant chemoradiation (ART)
    • Appropriate treatment for medically inoperable cases
    • Appropriateness of intensity-modulated radiation therapy (IMRT)

    Resources
    RAND/UCLA Appropriate Method User’s Manual
    Radiation Therapy for Cancers of the Colon, Rectum and Anus
    Gastrointestinal Cancer-Refresher 2017

    Author Society
    American Society for Radiation Oncology

    Previous version
    None

  • Disclaimer

    ASTRO guidelines present scientific, health, and safety information and may reflect scientific or medical opinion. They are available to ASTRO members and the public for educational and informational purposes only. Commercial use of any content in this guideline without the prior written consent of ASTRO is strictly prohibited.