Small-bowel displacement system for the sparing of Small bowel in three-dimensional conformal radiotherapy for cervical cancer

Huh, Seung Jae; Park, W.; Ju, Sang Gyu; Lee, J.E.; Han, Youngyih

doi:10.1016/j.clon.2004.06.027

“…In the 3D-CRT of rectal malignancies, a prone treatment position without a belly board compared to a supine posture results in the reduction of the irradiated small intestine volume [33]. In case of pelvic malignancies, a larger decrease in the small intestine exposure can be obtained by the additional use of a belly board in comparison with both prone position alone [34,35] or supine position [36,37]. The use of IMRT technique decreases bowel doses by 40-50%, as compared to 3D-CRT [38,39].…”

Section: Discussionmentioning

confidence: 99%

Prone Positioning on a Belly Board Decreases Rectal and Bowel Doses in Pelvic Intensity-Modulated Radiation Therapy (IMRT) for Prostate Cancer

Kószó

¹

,

Varga

²

,

Fodor

³

et al. 2018

Pathol. Oncol. Res.

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The presence of normal tissues in the irradiated volume limits dose escalation during pelvic radiotherapy (RT) for prostate cancer. Supine and prone positions on a belly board were compared by analyzing the exposure of organs at risk (OARs) using intensity modulated RT (IMRT). The prospective trial included 55 high risk, localized or locally advanced prostate cancer patients, receiving definitive image-guided RT. Computed tomography scanning for irradiation planning was carried out in both positions. Gross tumor volume, clinical and planning target volumes (PTV) and OARs were delineated, defining subprostatic and periprostatic rectal subsegments. At the height of the largest antero-posterior (AP) diameter of the prostate, rectal diameters and distance from the posterior prostate wall were measured. IMRT plans were generated. Normal tissue exposure and structure volumes were compared between supine and prone plans using paired t-test. In the volumes of the prostate, PTV, colon and small bowel, no significant differences were found. In prone position, all rectal volumes, diameters, and rectum-prostate distance were significantly higher, the irradiated colon and small bowel volume was lower in dose ranges of 20-40 Gy, and the exposure to all rectal segments was more favorable in 40-75 Gy dose ranges. No significant difference was found in the exposure of other OARs. Prone positioning on a belly board is an appropriate positioning method aiming rectum and bowel protection during pelvic IMRT of prostate cancer. The relative reduction in rectal exposure might be a consequence of the slight departure between the prostate and rectal wall.

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“…1,3,4 The use of open tabletop devices or the bellyboard, where patients are in the prone position, has been described previously. [2][3][4][5][6] Positioning of patients with gynecologic tumours for radiotherapy has proven to be relatively inaccurate. 7 Misspositioning of the patient can give rise to complications or influence the results of the treatment.…”

Section: Introductionmentioning

confidence: 99%

Implementing of the offline setup correction protocol in pelvic radiotherapy: safety margins and number of images

Kasabašić¹,

Faj²,

Belaj³

et al. 2007

Radiology and Oncology

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“…In case of gynecological and rectal tumors, a belly board assisted prone position using IMRT results in a further reduction in the irradiated volume of the small intestine, even in low dose areas [40,41]. The advantage of the use of a belly board is also confirmed in postoperatively irradiated patients [42,43], which might be the consequence of the significantly higher mobilization of the small intestine loops. The findings of Fu et al [44] show that the gain of the use of a belly board is greater if the irradiated small intestine volume close to the target volume is larger.…”

Section: Discussionmentioning

confidence: 99%

“…In 3D-CRT of rectal malignancies, the prone treatment position even without a belly board results in the reduction of the irradiated small intestine volume as compared to the supine posture [41]. In case of pelvic malignancies, a larger decrease in the small intestine exposure can be obtained by the additional use of a belly board in comparison with both prone position alone [42,43] or supine position [44,45]. The use of IMRT technique decreases bowel doses by 40-50%, as compared to 3D-CRT [46,47].…”

Section: Pqi According To Technique In Patients Receiving Partial Brementioning

confidence: 99%

Individualised radiotherapy serving reduced toxicity in breast and prostate cancer

Kószó¹

0

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The presence of normal tissues in the irradiated volume limits dose escalation during pelvic radiotherapy (RT) for prostate cancer. Supine and prone positions on a belly board were compared by analyzing the exposure of organs at risk (OARs) using intensity modulated RT (IMRT). The prospective trial included 55 high risk, localized or locally advanced prostate cancer patients, receiving definitive image-guided RT. Computed tomography scanning for irradiation planning was carried out in both positions. Gross tumor volume, clinical and planning target volumes (PTV) and OARs were delineated, defining subprostatic and periprostatic rectal subsegments. At the height of the largest antero-posterior (AP) diameter of the prostate, rectal diameters and distance from the posterior prostate wall were measured. IMRT plans were generated. Normal tissue exposure and structure volumes were compared between supine and prone plans using paired t-test. In the volumes of the prostate, PTV, colon and small bowel, no significant differences were found. In prone position, all rectal volumes, diameters, and rectum-prostate distance were significantly higher, the irradiated colon and small bowel volume was lower in dose ranges of 20-40 Gy, and the exposure to all rectal segments was more favorable in 40-75 Gy dose ranges. No significant difference was found in the exposure of other OARs. Prone positioning on a belly board is an appropriate positioning method aiming rectum and bowel protection during pelvic IMRT of prostate cancer. The relative reduction in rectal exposure might be a consequence of the slight departure between the prostate and rectal wall.

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Small-bowel displacement system for the sparing of Small bowel in three-dimensional conformal radiotherapy for cervical cancer

Cited by 11 publications

References 21 publications

Prone Positioning on a Belly Board Decreases Rectal and Bowel Doses in Pelvic Intensity-Modulated Radiation Therapy (IMRT) for Prostate Cancer

Prone Positioning on a Belly Board Decreases Rectal and Bowel Doses in Pelvic Intensity-Modulated Radiation Therapy (IMRT) for Prostate Cancer

Implementing of the offline setup correction protocol in pelvic radiotherapy: safety margins and number of images

Individualised radiotherapy serving reduced toxicity in breast and prostate cancer

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