Prospective radiotherapy quality Assurance leads to delineation guideline refinements for recurrent rectal cancer: Experience from the PelvEx II study.

Introduction: Target volume delineation in locally recurrent rectal cancer (LRRC) is clinically challenging. To ensure the quality of chemoradiotherapy (CRT) within the PelvEx II trial, a delineation guideline was developed and prospective quality assurance (QA) was instated for all patients. Guideline adherence, the impact of QA on target volumes, and subsequent guideline refinements are described in this paper.

Development of a consensus-based delineation guideline for locally recurrent rectal cancer.

Background And Purpose: Neoadjuvant chemoradiotherapy (nCRT) is used in locally recurrent rectal cancer (LRRC) to increase chances of a radical surgical resection. Delineation in LRRC is hampered by complex disease presentation and limited clinical exposure. Within the PelvEx II trial, evaluating the benefit of chemotherapy preceding nCRT for LRRC, a delineation guideline was developed by an expert LRRC team.

Selected stage IV rectal cancer patients managed by the watch-and-wait approach after pelvic radiotherapy: a good alternative to total mesorectal excision surgery?

Aim: The aim of this study was to assess the clinical and oncological outcome of a selected group of stage IV rectal cancer patients managed by the watch-and-wait approach following a (near-)complete response of the primary rectal tumour after radiotherapy.

Method: Patients registered in the Dutch watch-and-wait registry since 2004 were selected when diagnosed with synchronous stage IV rectal cancer. Data on patient characteristics, treatment details, follow-up and survival were collected.

Oncological Outcomes and Hospital Costs of the Treatment in Patients With Rectal Cancer: Watch-and-Wait Policy and Standard Surgical Treatment.

Background: Little is known about the costs of the current treatment strategy in locally advanced rectal cancer, in which patients with a clinical complete response after chemoradiotherapy are treated in a watch-and-wait policy.

Objective: The aim of this study is to present the oncological outcome and hospital costs of patients with a complete response after chemoradiotherapy (watch-and-wait policy) and patients with an incomplete response after chemoradiotherapy (total mesorectal excision).

Design: This was a cohort study.