Lower GI 2016

Improving IMRT in anal cancer: skin tox

- Rotational technique may help (better conformality) - Explicit inclusion of constrained «skin region» & PTV corrections near the skin….(be careful…) - Role of IGRT - Impact of bolus - Inguinal nodes vs no inguinal node (role of sentinel lymphonode, PET imaging…)

Joseph 2015 «…. PTV45 volumes were limited to 3–5 mm from the skin surface. Bolus was used for 4 patients with perianal extension.»