TY - JOUR
T1 - The 2017 Assisi Think Tank Meeting on rectal cancer: A positioning paper.
AU - Valentini, Vincenzo
AU - Marijnen, Corrie
AU - Beets, Geerard
AU - Bujko, Krzysztof
AU - De Bari, Berardino
AU - Cervantes, Andres
AU - Chiloiro, Giuditta
AU - Coco, Claudio
AU - Gambacorta, Maria Antonietta
AU - Glynne-Jones, Robert
AU - Haustermans, Karin
AU - Meldolesi, Elisa
AU - Peters, Femke
AU - Rödel, Claus
AU - Rutten, Harm
AU - Van De Velde, Cornelis
AU - Aristei, Cynthia
PY - 2020
Y1 - 2020
N2 - Abstract
BACKGROUND AND PURPOSES:
To describe current practice in the management of rectal cancer, to identify uncertainties that usually arise in the multidisciplinary team (MDT)'s discussions ('grey zones') and propose next generation studies which may provide answers to them.
MATERIALS AND METHODS:
A questionnaire on the areas of controversy in managing T2, T3 and T4 rectal cancer was drawn up and distributed to the Rectal-Assisi Think Tank Meeting (ATTM) Expert European Board. Less than 70% agreement on a treatment option was indicated as uncertainty and selected as a 'grey zone'. Topics with large disagreement were selected by the task force group for discussion at the Rectal-ATTM.
RESULTS:
The controversial clinical issues that had been identified within cT2-cT3-cT4 needed further investigation. The discussions focused on the role of (1) neoadjuvant therapy and organ preservation on cT2-3a low-middle rectal cancer; (2) neoadjuvant therapy in cT3 low rectal cancer without high risk features; (3) total neoadjuvant therapy, radiotherapy boost and the best chemo-radiotherapy schedule in T4 tumors. A description of each area of investigation and trial proposals are reported.
CONCLUSION:
The meeting successfully identified 'grey zones' and, in the light of new evidence, proposed clinical trials for treatment of early, intermediate and advanced stage rectal cancer.
AB - Abstract
BACKGROUND AND PURPOSES:
To describe current practice in the management of rectal cancer, to identify uncertainties that usually arise in the multidisciplinary team (MDT)'s discussions ('grey zones') and propose next generation studies which may provide answers to them.
MATERIALS AND METHODS:
A questionnaire on the areas of controversy in managing T2, T3 and T4 rectal cancer was drawn up and distributed to the Rectal-Assisi Think Tank Meeting (ATTM) Expert European Board. Less than 70% agreement on a treatment option was indicated as uncertainty and selected as a 'grey zone'. Topics with large disagreement were selected by the task force group for discussion at the Rectal-ATTM.
RESULTS:
The controversial clinical issues that had been identified within cT2-cT3-cT4 needed further investigation. The discussions focused on the role of (1) neoadjuvant therapy and organ preservation on cT2-3a low-middle rectal cancer; (2) neoadjuvant therapy in cT3 low rectal cancer without high risk features; (3) total neoadjuvant therapy, radiotherapy boost and the best chemo-radiotherapy schedule in T4 tumors. A description of each area of investigation and trial proposals are reported.
CONCLUSION:
The meeting successfully identified 'grey zones' and, in the light of new evidence, proposed clinical trials for treatment of early, intermediate and advanced stage rectal cancer.
KW - Rectal cancer
KW - Rectal cancer
UR - http://hdl.handle.net/10807/147725
U2 - 10.1016/j.radonc.2019.07.001
DO - 10.1016/j.radonc.2019.07.001
M3 - Article
SN - 0167-8140
SP - 6
EP - 16
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
ER -