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Bulletin du Cancer. Volume 96, Number 7, 45-51, juillet-août 2009, Electronic journal of oncology

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Author(s) : Nicolas Magné, Jean-François Daisne, Luigi Moretti, Dorothée Berben, Nicolas Meert, Ruth Alen, Samuel Bral, Ann Van Cleef, Karin Haustermans, Paul Van Houtte, Pierre Scalliet

Summary : The aim of the present study was to perform a rectal cancer practice survey in order to re-assess in 2005 the Belgian state of the art. A questionnaire based on the past 1999 peer review, supplemented with general questions, was circulated to 16 radiotherapy centres in Belgium. A case was also proposed for treatment planification. In 2005, a formal multidisciplinary team was in place in all visited centres. Endorectal ultrasound, colonoscopy, CEA and an initial pathological diagnosis were standard procedure in all centres. For T1-2N0, the majority of centres do not perform a preoperative treatment\; for T3N0, a majority proposes a preoperative radiochemotherapy. For all T3-4 any N, or any T-N involved, a neoadjuvant preoperative treatment is prescribed. Fractionation is conventional (1.8 Gy/d, five times a week). Analysing the practical case, the mean value for CTV and PTV volume was 393 (SD: 126) and 781 cm 3 (SD: 105), respectively. Mean D min and D max of 92 and 106.5%, respectively, were measured in the PTV. From clinical point of view, standards concepts are emerging and spreading for staging and for treatment options. Nevertheless, there is still a need for standardization of volumes and delineation standards.

Keywords : peer review, practice survey, radiotherapy, rectal cancer, quality assurance