{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T09:17:06Z","timestamp":1775899026149,"version":"3.50.1"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>In the last decade, the role of radiotherapy in rectal cancer has changed significantly with the introduction of total neoadjuvant therapy (TNT) and nonoperative management (NOM). For the setting of irradiation field in rectal cancer, the pararectal, lateral lymph nodes, and those along the inferior mesenteric artery (IMA) are most important. In total mesorectal excision (TME), the root of the IMA is dissected. In the atlas of pelvic irradiation for rectal cancer, the setting of the upper margin of the mesorectum varies from atlas to atlas, and no atlas sets the upper margin of the mesorectum to the root of the IMA. In particular, there is no consensus on the definition of anatomical boundaries regarding the lymph nodes along the superior rectal artery (SRA). The upper margin of the irradiation field in clinical trials of preoperative radiotherapy and TNT is generally set at the level of the internal and external iliac artery branches, L5\/S1, or S2\/S3. However, it is not necessary to include the entire mesorectum to the root of the IMA in patients undergoing preoperative radiotherapy plus TME. Conversely, for patients receiving NOM, the irradiation field may have to include the mesorectum to the IMA root, though the incidence of lymph node metastasis and gastrointestinal adverse events merits consideration. It is increasingly important to determine the extent of clinical target volume around the SRA region and the setting of the upper margin of the irradiation field after formulating the treatment policy together with the surgeons and medical oncologists.<\/jats:p>","DOI":"10.1093\/jrr\/rraf013","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T23:07:48Z","timestamp":1743376068000},"page":"203-211","source":"Crossref","is-referenced-by-count":1,"title":["Contouring atlas and essential points for radiotherapy in rectal cancer"],"prefix":"10.1093","volume":"66","author":[{"given":"Keiko Nemoto","family":"Murofushi","sequence":"first","affiliation":[{"name":"Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital , 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kayoko","family":"Tsujino","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Hyogo Cancer Center , 13-70 Kitaojicho, Akashi-shi, Hyogo, 673-0021,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinori","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Showa University School of Medicine , 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiko","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Gunma University Graduate School of Medicine , 3-39-22 Showa-machi, Maebashi-shi, Gunma 371-8511,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Doi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Kindai University Faculty of Medicine , 377-2, Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirofumi","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Radiation and Proton Therapy Center, Shizuoka Cancer Center , 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masakatsu","family":"Onozawa","sequence":"additional","affiliation":[{"name":"Funabashi Municipal Medical Center , 1-21-1 Kanasugi, Funabashi-shi, Chiba, 273-8588,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terufumi","family":"Kawamoto","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Juntendo University Graduate School of Medicine , 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8431,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norio","family":"Katoh","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Hokkaido University Faculty of Medicine , N15-W7, Kitaku, Sapporo 060-868,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiichi","family":"Jingu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tohoku University Graduate School of Medicine , 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsuya","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Radiology, Keio University School of Medicine , 35, Shinano, Shinjuku-ku, Tokyo 160-8582,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiji","family":"Nihei","sequence":"additional","affiliation":[{"name":"Department of 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Kamigyo-ku, Kyoto 602-8566,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Igaki","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center Hospital , 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"2025052306520511500_ref1","doi-asserted-by":"publisher","first-page":"5644","DOI":"10.1200\/JCO.2005.08.144","article-title":"Swedish rectal cancer trial: long lasting benefits from radiotherapy on survival and local recurrence rate","volume":"23","author":"Folkesson","year":"2005","journal-title":"J Clin Oncol"},{"key":"2025052306520511500_ref2","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1056\/NEJMoa010580","article-title":"Preoperative radiotherapy combined with total mesorectal excision for resectable rectal 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