Minimization of small bowel volume within treatment fields utilizing customized “belly boards”

Recent advances in the management of radiation colitis

“…The toxicity of radiation is directly related to the volume of small bowel being irradiated [93] . In many patients, therapy in the prone position with a special "belly" board allows the protrusion of the small intestine out of the radiation field [94,95] . Patients should be instructed to maintain a full bladder during the radiation session, which mechanically displaces the intestine out of the pelvis [96] .…”

Pelvic nodal dose escalation with prostate hypofractionation using conformal avoidance defined (H-CAD) intensity modulated radiation therapy

“…While bowel displacement techniques [9,37] have assisted in limiting side effects, it is unclear if they are sufficient to allow a meaningful increase in elective nodal dose without increasing GI toxicity. Furthermore, conventional 4-field pelvic radiotherapy does not allow for significant sparing of rectum and bladder.…”

“…Intravenous contrast was used in all patients with a normal serum creatinine level. A planning CT was obtained with the patient placed in the prone position in a bowel displacement device (bellyboard) [9]. The CT study was acquired with a 2.5 mm slice thickness.…”

“…Patients were usually treated prone in a bowel displacement device (bellyboard) [9]. A rectal displacement balloon was used [8] and daily pretreatment prostate and pelvis localization required.…”

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“…A refinement of the small bowel research has been used to reduce the amount of small bowel in pelvic treatment fields 8 . Shanahan et al studied patients who had planning CT scans carried out in both supine and prone positions, with the patient lying on a 'belly board' for the prone position.…”