Some patients may benefit from radiation therapy:

• patients with high-risk rectal cancer (neoadjuvant therapy)
• patients with symptomatic, non-resectable locally advanced rectal cancer who may benefit from radiation therapy with or without concurrent chemotherapy given with palliative intent
• patients with colon cancer where the tumour has penetrated a fixed structure.

Timeframe for starting treatment

Neoadjuvant radiation therapy should begin within three weeks of the MDM.

Training and experience required of the appropriate specialists

The appropriate specialist should be a radiation oncologist (FRANZCR) with adequate training and experience with the agreed scope of practice in colorectal cancer.

The training and experience of the radiation oncologist should be documented.

Health service unit characteristics

To provide safe and quality care for patients having radiation therapy, health services should have these features:

• linear accelerator (LINAC) capable of image-guided radiation therapy (IGRT)
• dedicated CT planning
• access to MRI and PET imaging
• automatic record-verify of all radiation treatments delivered
• a treatment planning system
• trained medical physicists, radiation therapists and nurses with radiation therapy experience
• coordination for combined therapy with systemic therapy, especially where facilities are not co-located
• participation in Australian Clinical Dosimetry Service audits
• an incident management system linked with a quality management system.