ESTRO consensus guidelines on GTV delineation and dose-escalation in rectal cancer

Giuditta Chiloiro; Angela Romano; Regina Beets-Tan; Krzysztof Bujko; Davide Cusumano; Emmanouil Fokas; Karin Haustermans; Florence Huguet; Martijn Pw Intven; Corrie Am Marijnen; Ilaria Nacci; Iris D Nagtegaal; Femke P Peters; Alexandra Stewart; Vincenzo Valentini; Maria Antonietta Gambacorta

doi:10.1016/j.ctro.2026.101131

ESTRO consensus guidelines on GTV delineation and dose-escalation in rectal cancer

Giuditta Chiloiro
, Angela Romano^*
, Regina Beets-Tan
, Krzysztof Bujko
, Davide Cusumano
, Emmanouil Fokas
, Karin Haustermans
, Florence Huguet
, Martijn Pw Intven
, Corrie Am Marijnen
, Ilaria Nacci
, Iris D Nagtegaal
, Femke P Peters
, Alexandra Stewart
, Vincenzo Valentini
, Maria Antonietta Gambacorta

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

•Dose escalation, in rectal cancer, is defined as radiotherapy doses exceeding 54 Gy.•MRI-based GTV definition is central to dose-escalated rectal cancer RT.•Dose escalation supports organ preservation in selected rectal cancer patients.•Delphi methodology achieved consensus across key clinical and imaging domains.

Original language	English
Article number	101131
Journal	Clinical and translational radiation oncology
Volume	58
DOIs	https://doi.org/10.1016/j.ctro.2026.101131
Publication status	Published - May 2026

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10.1016/j.ctro.2026.101131Licence: CC BY-NC-ND

ESTRO consensus guidelines on GTV delineation and dose-escalation in rectal cancerFinal published version, 1.69 MBLicence: CC BY-NC-ND

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Chiloiro, G., Romano, A., Beets-Tan, R., Bujko, K., Cusumano, D., Fokas, E., Haustermans, K., Huguet, F., Intven, M. P., Marijnen, C. A., Nacci, I., Nagtegaal, I. D., Peters, F. P., Stewart, A., Valentini, V., & Gambacorta, M. A. (2026). ESTRO consensus guidelines on GTV delineation and dose-escalation in rectal cancer. Clinical and translational radiation oncology, 58, Article 101131. https://doi.org/10.1016/j.ctro.2026.101131

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title = "ESTRO consensus guidelines on GTV delineation and dose-escalation in rectal cancer",

abstract = "•Dose escalation, in rectal cancer, is defined as radiotherapy doses exceeding 54 Gy.•MRI-based GTV definition is central to dose-escalated rectal cancer RT.•Dose escalation supports organ preservation in selected rectal cancer patients.•Delphi methodology achieved consensus across key clinical and imaging domains.",

author = "Giuditta Chiloiro and Angela Romano and Regina Beets-Tan and Krzysztof Bujko and Davide Cusumano and Emmanouil Fokas and Karin Haustermans and Florence Huguet and Intven, \{Martijn Pw\} and Marijnen, \{Corrie Am\} and Ilaria Nacci and Nagtegaal, \{Iris D\} and Peters, \{Femke P\} and Alexandra Stewart and Vincenzo Valentini and Gambacorta, \{Maria Antonietta\}",

note = "{\textcopyright} 2026 The Authors. Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology.",

year = "2026",

month = may,

doi = "10.1016/j.ctro.2026.101131",

language = "English",

volume = "58",

journal = "Clinical and translational radiation oncology",

issn = "2405-6308",

publisher = "Elsevier Ireland Ltd",

}

Chiloiro, G, Romano, A, Beets-Tan, R, Bujko, K, Cusumano, D, Fokas, E, Haustermans, K, Huguet, F, Intven, MP, Marijnen, CA, Nacci, I, Nagtegaal, ID, Peters, FP, Stewart, A, Valentini, V & Gambacorta, MA 2026, 'ESTRO consensus guidelines on GTV delineation and dose-escalation in rectal cancer', Clinical and translational radiation oncology, vol. 58, 101131. https://doi.org/10.1016/j.ctro.2026.101131

TY - JOUR

T1 - ESTRO consensus guidelines on GTV delineation and dose-escalation in rectal cancer

AU - Chiloiro, Giuditta

AU - Romano, Angela

AU - Beets-Tan, Regina

AU - Bujko, Krzysztof

AU - Cusumano, Davide

AU - Fokas, Emmanouil

AU - Haustermans, Karin

AU - Huguet, Florence

AU - Intven, Martijn Pw

AU - Marijnen, Corrie Am

AU - Nacci, Ilaria

AU - Nagtegaal, Iris D

AU - Peters, Femke P

AU - Stewart, Alexandra

AU - Valentini, Vincenzo

AU - Gambacorta, Maria Antonietta

PY - 2026/5

Y1 - 2026/5

N2 - •Dose escalation, in rectal cancer, is defined as radiotherapy doses exceeding 54 Gy.•MRI-based GTV definition is central to dose-escalated rectal cancer RT.•Dose escalation supports organ preservation in selected rectal cancer patients.•Delphi methodology achieved consensus across key clinical and imaging domains.

AB - •Dose escalation, in rectal cancer, is defined as radiotherapy doses exceeding 54 Gy.•MRI-based GTV definition is central to dose-escalated rectal cancer RT.•Dose escalation supports organ preservation in selected rectal cancer patients.•Delphi methodology achieved consensus across key clinical and imaging domains.

U2 - 10.1016/j.ctro.2026.101131

DO - 10.1016/j.ctro.2026.101131

M3 - Article

C2 - 41783373

SN - 2405-6308

VL - 58

JO - Clinical and translational radiation oncology

JF - Clinical and translational radiation oncology

M1 - 101131

ER -

ESTRO consensus guidelines on GTV delineation and dose-escalation in rectal cancer

Abstract

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