TARGET DELINEATION IN ANAL CANAL CANCER BY DR KANHU

1. ROW CASE - RADIATION ONCOLOGY WORKFLOW
TARGET DELINEATION IN ANAL CANCER
Dr Raghav Gaur
Dr Kanhu Charan Patro
MD,DNB(Radiation Oncology),MBA,FICRO,FAROI(USA),PDCR,CEPC
Clinical Director, HOD (Radiation Oncology)
ISRo- Institute of Stereotactic Radiation oncology
Mahatma Gandhi Cancer Hospital & Research Institute, Visakhapatnam
drkcpatro@gmail.com /M- +91-9160470564/ www.drkanhupatro.com

2. Reference article

3. Imaging finding

4. Endoscopy and DRE

5. GCP TABLE

6. GTVp- AXIAL- CLINICRADOLOGICAL

7. GTVp- CORONAL- CLINICRADOLOGICAL

8. GTVp- SAGITTAL- CLINICRADOLOGICAL

9. GTVn- CLINICRADOLOGICAL

10. CTVpHR
GTVp + 2-2.5cms

11. CTVpHR- LOWER MARGIN-2cm

12. CTVn HR
GTVn + 0.5cm

13. CTVpLR
Includes mesorectum + 1cm into the anterior organ

14. MESORECTUM -SUP
Bifurcation of Inferior Mesenteric Artery

15. MESORECTUM -INF
Insertion of Levator Ani muscle into External Sphincter

16. MESORECTUM -ANT & POST
Anterior : posterior
border of anterior
pelvic organ
Posterior : Anterior
surface of the sacrum
and coccyx

17. ANTERIOR ORGAN
1cm into the anterior pelvic organ

18. CTVnLR
To start screening from the bifurcation of Common Iliac
artery

19. CTVn COMMON ILIAC
7mm margin around the vessel

20. CTVn INTERNAL ILIAC

21. CTVn LR- EXTERNAL ILIAC

22. CTVn LR- OBTURATOR

23. CTVn LR- PRESACRAL

24. CTVn LR- INGUINAL

25. CTVn LR- INGUINAL SUPERIOR
Where external iliac exits the pelvis

26. CTVn LR- INGUINAL INFERIOR
The great saphenous vein enters the femoral vein

27. PTV LR
Receives a dose of 45Gy

28. PTV-HR
Receives a complete dose of 54- 59.4Gy

29. DOSE SCHEDULE

30. Scan through Google lens
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