{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T02:07:43Z","timestamp":1783908463919,"version":"3.55.0"},"reference-count":20,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In patients with rectal cancer, daily fluctuations in rectal volume often lead to large deformations of the target volume that cannot be corrected by adjusting the radiation couch. The main aim of the study was to determine the deviation of all three thirds of the rectum from the reference position and to determine whether these deviations are influenced by the alignments to the bony structures (the sacrum) and the posterior rectal wall.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>The conduct of the study was divided into review of the database, contouring of the anatomic structures on the cone-beam computed tomography (CBCT) images, data collection of the deviations and data output, with the alignment to the bony structures (the sacrum) - and the alignment to the posterior rectal wall performed separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty preoperatively irradiated patients were included in the study. The analysis revealed statistically significant differences in terms of alignment to the bony structures for different variations of the rectal thirds in the anterior (+), posterior (+), posterior (\u2212), left (\u2212), right (+) and right (\u2212) directions. With regard to the alignment to the posterior rectal wall, the analysis showed statistically significant differences for different variations of the rectal thirds in directions anterior (+), posterior (+), posterior (\u2212), left (\u2212), right (+), right (\u2212) and bone (+).\n                      <jats:italic>(The positive value (+) means that the rectum was larger and the negative value (\u2212) means that the rectum is smaller than in the reference position of the CT simulator images.)<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The position of the rectal thirds changes daily in alignment with the bony structures (the sacrum), and in alignment with the posterior rectal wall.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2478\/raon-2025-0020","type":"journal-article","created":{"date-parts":[[2025,6,22]],"date-time":"2025-06-22T14:18:11Z","timestamp":1750601891000},"page":"277-284","source":"Crossref","is-referenced-by-count":0,"title":["Deviation of the upper, middle and lower thirds of the rectum during irradiation of rectum cancer"],"prefix":"10.2478","volume":"59","author":[{"given":"Klemen","family":"Salmic","sequence":"first","affiliation":[{"name":"Institute of Oncology Ljubljana, Department of Radiotherapy , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerija Zager","family":"Marcius","sequence":"additional","affiliation":[{"name":"Institute of Oncology Ljubljana, Department of Radiotherapy , Ljubljana , Slovenia"},{"name":"University of Ljubljana, Faculty of Health Sciences, Department of Medical Imaging and Radiotherapy , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irena","family":"Oblak","sequence":"additional","affiliation":[{"name":"Institute of Oncology Ljubljana, Department of Radiotherapy , Ljubljana , Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,6,6]]},"reference":[{"key":"2026071215474140129_j_raon-2025-0020_ref_001","doi-asserted-by":"crossref","unstructured":"Torras MG, Canals E, Jurado-Bruggeman D, Mar\u00edn-Borras S, Maci\u00e0 M, Jov\u00e9 J, et al. Clinical audit of the radiotherapy process in rectal cancer: clinical practice guidelines and quality certification do not avert variability in clinical practice. Transl Oncol 2018; 11: 794-9. doi: 10.1016\/j.tranon.2018.03.015","DOI":"10.1016\/j.tranon.2018.03.015"},{"key":"2026071215474140129_j_raon-2025-0020_ref_002","doi-asserted-by":"crossref","unstructured":"Joye I, Macq G, Vaes E, Roels S, Lambrecht M, Pelgrims A, et al. Do refined consensus guidelines improve the uniformity of clinical target volume delineation for rectal cancer? Results of a national review project. Radiother Oncol 2016; 120: 202-6. doi: 10.1016\/j.radonc.2016.06.005","DOI":"10.1016\/j.radonc.2016.06.005"},{"key":"2026071215474140129_j_raon-2025-0020_ref_003","doi-asserted-by":"crossref","unstructured":"Wo JY, Anker CJ, Ashman JB, Bhadkamkar NA, Bradfield L, Chang DT, et al. Radiation therapy for rectal cancer: executive summary of an ASTRO clinical practice guideline. Pract Radiat Oncol 2021; 11: 13-25. doi: 10.1016\/j.prro.2020.08.004","DOI":"10.1016\/j.prro.2020.08.004"},{"key":"2026071215474140129_j_raon-2025-0020_ref_004","doi-asserted-by":"crossref","unstructured":"De Jong R, Crama KF, Visser J, Van Wieringen N, Wiersma J, Geijsen ED, et al. Online adaptive radiotherapy compared to plan selection for rectal cancer: quantifying the benefit. Radiat Oncol 2020; 15: 1-9. doi: 10.1186\/s13014-020-01597-1","DOI":"10.1186\/s13014-020-01597-1"},{"key":"2026071215474140129_j_raon-2025-0020_ref_005","doi-asserted-by":"crossref","unstructured":"Brierley JD, Dawson LA, Sampson E, Bayley A, Scott S, Moseley JL, et al. Rectal motion in patients receiving preoperative radiotherapy for carcinoma of the rectum. Int J Radiat Oncol Biol Phys 2011; 80: 97-102. doi: 10.1016\/j.ijrobp.2010.01.042","DOI":"10.1016\/j.ijrobp.2010.01.042"},{"key":"2026071215474140129_j_raon-2025-0020_ref_006","doi-asserted-by":"crossref","unstructured":"Herrmann H, Seppenwoolde Y, Georg D, Widder J. Image guidance: past and future of radiotherapy. Radiologe 2019; 59: 21-7. doi: 10.1007\/s00117-019-0573-y","DOI":"10.1007\/s00117-019-0573-y"},{"key":"2026071215474140129_j_raon-2025-0020_ref_007","doi-asserted-by":"crossref","unstructured":"Valentini V, Gambacorta MA, Barbaro B, Chiloiro G, Coco C, Das P, et al. International consensus guidelines on clinical target volume delineation in rectal cancer. Radiother Oncol 2016; 120: 195-201. doi: 10.1016\/j.radonc.2016.07.017","DOI":"10.1016\/j.radonc.2016.07.017"},{"key":"2026071215474140129_j_raon-2025-0020_ref_008","doi-asserted-by":"crossref","unstructured":"Kleijnen JPJE, van Asselen B, Intven M, Burbach JPM, Philippens MEP, Lagendijk JJW, et al. Does setup on rectal wall improve rectal cancer boost radiotherapy? Radiat Oncol 2018; 13: 61. doi: 10.1186\/s13014-018-1011-4","DOI":"10.1186\/s13014-018-1011-4"},{"key":"2026071215474140129_j_raon-2025-0020_ref_009","doi-asserted-by":"crossref","unstructured":"McNair H, Buijs M. Image guided radiotherapy moving towards real time adaptive radiotherapy; global positioning system for radiotherapy? Tech Innov Patient Support Radiat Oncol 2019; 12: 1-2. doi: 10.1016\/j.tipsro.2019.10.006","DOI":"10.1016\/j.tipsro.2019.10.006"},{"key":"2026071215474140129_j_raon-2025-0020_ref_010","doi-asserted-by":"crossref","unstructured":"Stankiewicz M, Li W, Rosewall T, Tadic T, Dickie C, Velec M. Patterns of practice of adaptive re-planning for anatomic variances during cone-beam CT guided radiotherapy. Tech Innov Patient Support Radiat Oncol 2019; 12: 50-5. doi: 10.1016\/j.tipsro.2019.10.003","DOI":"10.1016\/j.tipsro.2019.10.003"},{"key":"2026071215474140129_j_raon-2025-0020_ref_011","doi-asserted-by":"crossref","unstructured":"Nijkamp J, Marijnen C, Van Herk M, Van Triest B, Sonke JJ. Adaptive radiotherapy for long course neo-adjuvant treatment of rectal cancer. Radiother Oncol 2012; 103: 353-9. doi: 10.1016\/j.radonc.2012.02.013","DOI":"10.1016\/j.radonc.2012.02.013"},{"key":"2026071215474140129_j_raon-2025-0020_ref_012","doi-asserted-by":"crossref","unstructured":"Intven MPW, de Mol van Otterloo SR, Mook S, Doornaert PAH, de Groot-van Breugel EN, Sikkes GG, et al. Online adaptive MR-guided radiotherapy for rectal cancer; feasibility of the workflow on a 1.5T MR-linac: clinical implementation and initial experience. Radiother Oncol 2021; 154: 172-8. doi: 10.1016\/j.radonc.2020.09.024","DOI":"10.1016\/j.radonc.2020.09.024"},{"key":"2026071215474140129_j_raon-2025-0020_ref_013","doi-asserted-by":"crossref","unstructured":"Chiloiro G, Boldrini L, Meldolesi E, Re A, Cellini F, Cusumano D, et al. MR-guided radiotherapy in rectal cancer: first clinical experience of an innovative technology. Clin Transl Radiat Oncol 2019; 18: 80-6. doi: 10.1016\/j. ctro.2019.04.006","DOI":"10.1016\/j.ctro.2019.04.006"},{"key":"2026071215474140129_j_raon-2025-0020_ref_014","doi-asserted-by":"crossref","unstructured":"Roeske JC, Forman JD, Mesina CF, He T, Pelizzari CA, Fontenla E, et al. Evaluation of changes in the size and location of the prostate, seminal vesicles, a course of external bladder, and rectum during beam radiation therapy. Int J Rad Oncol Biol Phys 1995; 33: 1321-29. doi: 10.1016\/0360-3016(95)00225-1","DOI":"10.1016\/0360-3016(95)00225-1"},{"key":"2026071215474140129_j_raon-2025-0020_ref_015","doi-asserted-by":"crossref","unstructured":"Ten Haken RK, Forman JD, Heimburger DK, Gerhardsson A, McShan DL, Perez-Tanayo C, et al. Treatment planning issues related to prostate movement in response to differential filling of the rectum and bladder Int J Radiat Oncol Biol Phys 1991; 20: 1317-24. doi: 10.1016\/0360-3016(91)90244-x","DOI":"10.1016\/0360-3016(91)90244-X"},{"key":"2026071215474140129_j_raon-2025-0020_ref_016","doi-asserted-by":"crossref","unstructured":"Mak D, Gill S, Paul R, Stillie A, Haworth A, Kron T, et al. Seminal vesicle interfraction displacement and margins in image guided radiotherapy for prostate cancer. Radiat Oncol 2012; 7: 139. doi: 10.1186\/1748-717X-7-139","DOI":"10.1186\/1748-717X-7-139"},{"key":"2026071215474140129_j_raon-2025-0020_ref_017","doi-asserted-by":"crossref","unstructured":"Yang S, Li T, Lee WR, Yin FF, Wu QJ. Exploring the margin recipe for online adaptive radiation therapy for intermediate-risk prostate cancer: an intrafractional seminal vesicles motion analysis. Int J Radiat Oncol Biol Phys 2017; 98: 473\u201380. doi: 10.1016\/j.ijrobp.2017.02.089","DOI":"10.1016\/j.ijrobp.2017.02.089"},{"key":"2026071215474140129_j_raon-2025-0020_ref_018","doi-asserted-by":"crossref","unstructured":"Nayttens JJ, Robertson JM, Yan D, Martinez A. The variability of the clinical target volume for rectal cancer due to internal organ motion during adjuvant treatment. Int J Radiat Oncol Biol Phys 2002; 53: 497-503. doi: 10.1016\/s0360-3016(02)02753-0","DOI":"10.1016\/S0360-3016(02)02753-0"},{"key":"2026071215474140129_j_raon-2025-0020_ref_019","doi-asserted-by":"crossref","unstructured":"Brierley JD, Dawson LA, Sampson E, Bayley A, Scott S, Moseley B, et al. Rectal motion in patients receiving preoperative radiotherapy for carcinoma of the rectum. Int J Radiat Oncol Biol Phys 2011; 80: 97-102. doi: 10.1016\/j.ijrobp.2010.01.042","DOI":"10.1016\/j.ijrobp.2010.01.042"},{"key":"2026071215474140129_j_raon-2025-0020_ref_020","doi-asserted-by":"crossref","unstructured":"Alickikus ZA, Kuru A, Aydin B, Akcay D, Gorken IB. The importance of mesorectum motion in determining PTV margins in rectal cancer patients treated with neoadjuvant radiotherapy. J Rad Research 2020; 61: 335-42. doi: 10.1093\/jrr\/rrz092","DOI":"10.1093\/jrr\/rrz092"}],"container-title":["Radiology and Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/reference-global.com\/pdf\/10.2478\/raon-2025-0020","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T01:30:37Z","timestamp":1783906237000},"score":1,"resource":{"primary":{"URL":"https:\/\/reference-global.com\/article\/10.2478\/raon-2025-0020"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,1]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,6,6]]},"published-print":{"date-parts":[[2025,6,1]]}},"alternative-id":["10.2478\/raon-2025-0020"],"URL":"https:\/\/doi.org\/10.2478\/raon-2025-0020","relation":{},"ISSN":["1581-3207"],"issn-type":[{"value":"1581-3207","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,1]]}}}