Lower GI 2017

Pelvic OARs constraints: sparing the bladder

- GU toxicity, a relatively minor problem («low» dose): threshold around 50-55Gy, whole organ for RTOG G3 late tox (Quantec 2010, Fiorino 2009) - No strong evidence of increased late GU tox compared to only surgery (Gilbert 2015) - Recent important updates of predictors of GU tox (more relevant for prostate ca pts, Landoni 2016) - Interplay between bladder filling and bowel sparing - The avoidance approach of the peritoneal space should include bladder to guarantee adequate sparing of bowel during treatment (possible systematic deviations)

Sanguineti 2008