We report on a clinical case of capecitabine-induced acute ileitis in a patient treated with pre-operative concurrent chemoradiation with capecitabine for locally advanced rectal cancer and provide a comprehensive literature review. This a rare, but life-threatening, clinical situation, that clinicians should be aware of. Severe persistent diarrhea is the most frequent clinical feature and computed tomography is a valid tool for diagnosis. Conservative management includes capecitabine withdrawal, antidiarrheal therapy and endovenous hydration, together with dietary modifications and broad-spectrum antibiotics. Pelvic irradiation represents an adjunctive risk factor, which may increase the likelihood of occurrence of terminal ileitis. Early recognition and prompt intervention are crucial for successful clinical management.

Background: Radiotherapy (RT) is a mainstay treatment for prostate cancer (PC). Accurate delineation of organs at risk (OARs) is crucial for optimizing the therapeutic window by minimizing side effects. Manual segmentation is time-consuming and prone to inter-operator variability. This study investigates the performance of Limbus^® Contour^® (LC), a deep learning-based auto-contouring software, in delineating pelvic structures in PC patients. Methods: We evaluated LC’s performance on key structures (bowel bag, bladder, rectum, sigmoid colon, and pelvic lymph nodes) in 52 patients. We compared auto-contoured structures with those manually delineated by radiation oncologists using different metrics. Results: LC achieved good agreement for the bladder (median Dice: 0.95) and rectum (median Dice: 0.83). However, limitations were observed for the bowel bag (median Dice: 0.64) and sigmoid colon (median Dice: 0.6), with inclusion of irrelevant structures. While the median Dice for pelvic lymph nodes was acceptable (0.73), the software lacked sub-regional differentiation, limiting its applicability in certain other oncologic settings. Conclusions: LC shows promise for automating OAR delineation in prostate radiotherapy, particularly for the bladder and rectum. Improvements are needed for bowel bag, sigmoid colon, and lymph node sub-regionalization. Further validation with a broader and larger patient cohort is recommended to assess generalizability.