ArticleBMC cancer2015
Reduced toxicity in the treatment of locally advanced rectal cancer: a comparison of volumetric modulated arc therapy and 3D conformal radiotherapy.
Article in BMC cancer, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Incidence, Risk Factors, and Management of Radiotherapy-Related Skin Toxicity in Rectoanal Cancer Patients: a Systematic Review and Meta-Analysis.Journal of gastrointestinal cancer · 2026Pooled it
- Late gastrointestinal toxicity after radiotherapy for rectal cancer: a systematic review.International journal of colorectal disease · 2020Pooled it
- Effect of dose escalation in neoadjuvant chemoradiotherapy of locally advanced rectal cancer on clinical and pathologic Response: A Systematic review andClinical and translational radiation oncology · 2026Review
- Efficacy comparison of preoperative versus postoperative radiotherapy for rectal cancer: an analysis based on the SEER database.Discover oncology · 2026Article
- Longitudinal assessment of quality of life and symptom burden in locally advanced rectal cancer patients receiving IMRT-based preoperative radiotherapy: A prospective cohort study.International journal of colorectal disease · 2025Article
- Treatment of non-small cell lung cancer: advances following the introduction of PET-CT and IMRT/VMAT.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Article
- Contouring atlas and essential points for radiotherapy in rectal cancer.Journal of radiation research · 2025Review
- Cracking the Code of Colorectal Cancer Screening: An Overview With a Focus on Current and Emerging Screening Methods.Cureus · 2025Review
- Intensity-modulated radiation therapy can reduce acute toxicities in long-course neoadjuvant radiation therapy combined with S-1 for locally advanced rectal cancer.International journal of clinical oncology · 2025Article
- Patient-reported outcomes after treatment for rectal cancer-A prospective nationwide study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2024Article
- The effect of Inc parameter on VMAT radiotherapy plans quality for rectal cancer using Monaco TPS.Journal of applied clinical medical physics · 2024Article
- Fully automated volumetric modulated arc therapy planning for locally advanced rectal cancer: feasibility and efficiency.Radiation oncology (London, England) · 2023Article
- Short-course preoperative radiotherapy increases pelvic fracture risk in rectal cancer.Clinical and translational radiation oncology · 2023Article
- Current and emerging therapeutic approaches for colorectal cancer: A comprehensive review.World journal of gastrointestinal surgery · 2023Review
- The in-silico feasibility of dose escalated, hypofractionated radiotherapy for rectal cancer.Clinical and translational radiation oncology · 2022Article
- Review
- Mesorectal shape variation in rectal cancer radiotherapy in prone position using a belly board.Physics and imaging in radiation oncology · 2021Article
- Dose-time fractionation schedules of preoperative radiotherapy and timing to surgery for rectal cancer.Therapeutic advances in medical oncology · 2020Review
- Rectal neuroendocrine carcinoma: case report of a rare entity and perspective review of promising agents.Drugs in context · 2020Review
- Robust dose planning objectives for mesorectal radiotherapy of early stage rectal cancer - A multicentre dose planning study.Technical innovations & patient support in radiation oncology · 2019Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExcellent dosimetric characteristics were demonstrated for volumetric modulated arc therapy (VMAT) in preoperative chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC). In a single-center retrospective analysis, we tested whether these advantages may translate into significant clinical benefits. We compared VMAT to conventional 3D conformal radiotherapy (3DCRT) in patients, homogeneously treated according to the control arm of the CAO/ARO/AIO-04 trial.
methodsCRT consisted of pelvic irradiation with 50.4/1.8Gy by VMAT (n = 81) or 3DCRT (n = 107) and two cycles of 5-fluorouracil. Standardized total mesorectal excision surgery was performed within 4-6 weeks. The tumor regression grading (TRG) was assessed by the Dworak score. Acute and late toxicity were evaluated via the Common Terminology Criteria for Adverse Events and the Late effects of normal tissues scale, respectively. Side effects greater than or equal to grade 3 were considered high-grade.
resultsMedian follow-up was 18.3 months in the VMAT group and 61.5 months in the 3DCRT group with no differences in TRG between them (p = 0.1727). VMAT treatment substantially reduced high-grade acute and late toxicity, with 5 % versus 20 % (p = 0.0081) and 6 % vs. 22 % (p = 0.0039), respectively. With regard to specific organs, differences were found in skin reaction (p = 0.019) and proctitis (p = 0.0153).
conclusionsVMAT treatment in preoperative CRT for LARC showed the potential to substantially reduce high-grade acute and late toxicity. Importantly, we could demonstrate that VMAT irradiation did not impair short-term oncological results. We conclude, that the reduced toxicity after VMAT irradiation may pave the way for more efficient systemic therapies, and hopefully improved patient survival in the multimodal treatment of LARC.
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