Evidence map›Paper›PMID 41815276›Full record

ReviewTechnical innovations & patient support in radiation oncology2026

Setup and target volume shape variation in rectal cancer radiotherapy: a systematic literature review.

Giovanna Mantello, Elena Galofaro, Cihan Gani, Daniel Portik, Lynsey Devlin, Robin De Roover, Ane Appelt, Rianne de Jong

Abstract readReview
In one paragraph

Review in Technical innovations & patient support in radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Giovanna MantelloRadiotherapy Department, Azienda Ospedaliero Universitaria delle Marche, 60126 Ancona, Italy.
Elena GalofaroRadiotherapy Department, Azienda Ospedaliero Universitaria delle Marche, 60126 Ancona, Italy.
Cihan GaniDepartment of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany.
Daniel PortikDepartment of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, the Netherlands.
Lynsey DevlinDepartment of Radiotherapy, The Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom.
Robin De RooverDepartment of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium.
Ane AppeltLeeds Institute of Medical Research, University of Leeds, Leeds, United Kingdom.
Rianne de JongDepartment of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: This systematic literature review aimed to evaluate treatment uncertainties associated with modern rectal cancer radiotherapy, focusing on systematic and random errors in setup and target volume (TV) shape variation, with the aim of supporting clinics in optimizing treatment accuracy and consistency in daily practice. Methods: A systematic literature review was conducted to quantify geometrical uncertainties with respect to setup and TV shape variations in the treatment of rectal cancer. It included studies reporting uncertainties for setup, CTV (Clinical Target Volume) shape variations (rectum and mesorectum), GTVp (Gross Tumor Volume - Primary Tumor), GTVn (Gross Tumor Volume - Nodes), and/or elective pelvic lymph nodes; excluding non-English language publications. Results: 196 reports were assessed for full text screening and 32 publications were selected for final reporting. Most authors utilized on board imaging to calculate setup errors and TV shape variation, and all reported substantial uncertainties. Setup uncertainty was reported to be very different for prone (w/o belly board) vs supine position, in favour of supine position. TV shape variation showed large systematic and random errors, especially for GTVp and the upper anterior part of the mesorectum. A subset of publications analyzed the positional uncertainties of elective draining lymph nodes, which are typically not removed during surgery, showing their small positional variations in relation to bone structures. Conclusion: Setup and TV shape variation are significant and non-negligible geometric uncertainties. Setup errors can largely be minimized with daily (2D or 3D) IGRT, whereas TV shape variations-particularly in the mesorectum-needs to be assessed daily with 3D imaging and requires anisotropic margins.

Indexed as

Image guided radiotherapyRectal cancerReviewSet upShape variationUncertainties

Identifiers

PMID41815276
PMCPMC12974187

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.