Table 5.

Optimization of late gastrointestinal tolerance after radiotherapy for localized prostate cancer.

	Delineation of structures
Recommendations	Contour the anal canal separately from the anorectal volume The anal canal starts at the anorectal junction, either at the level of the levators or where the rectum starts to angle downwards and posteriorly. It ends at the anal verge (use a radiopaque marker if possible). The pectinous line is at mid-canal, it measures ~3 to 4 cm in height. Pelvic floor muscles, sphincters and pudendal nerves could be identified during contouring
	Personalization of treatment
History of abdominal surgery Acute GI symptoms before, during or after RT Use of anticoagulants or hormonotherapy Elderly patient	Inform patients on the increased risk of late GIT
Tobacco and other cardiovascular risk factors	Tobacco cessation and control of risk factors
Biomarkers	Inform patients on the existence of these predictive tests that have not been validated yet in current routine practice