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Morphologic change of rectosigmoid colon using belly board and distended bladder protocol.

Cho Y, Chang JS, Kim MS, Lee J, Byun H, Kim N, Park SJ, Keum KC, Koom WS - Radiat Oncol J (2015)

Bottom Line: A total dose of 45 Gy was planned for the whole pelvic field with superior margin of the sacral promontory.The volume of rectosigmoid colon in the radiation field was significantly larger in group A (56.7 vs. 49.1 mL; p = 0.009).In dose volume histogram analysis, the mean irradiated volume was lower in patients in group B (V45 27.2 vs. 18.2 mL; p = 0.004).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, Korea.

ABSTRACT

Purpose: This study investigates morphologic change of the rectosigmoid colon using a belly board in prone position and distended bladder in patients with rectal cancer. We evaluate the possibility of excluding the proximal margin of anastomosis from the radiation field by straightening the rectosigmoid colon.

Materials and methods: Nineteen patients who received preoperative radiotherapy between 2006 and 2009 underwent simulation in a prone position (group A). These patients were compared to 19 patients treated using a belly board in prone position and a distended bladder protocol (group B). Rectosigmoid colon in the pelvic cavity was delineated on planning computed tomography (CT) images. A total dose of 45 Gy was planned for the whole pelvic field with superior margin of the sacral promontory. The volume and redundancy of rectosigmoid colon was assessed.

Results: Patients in group B had straighter rectosigmoid colons than those in group A (no redundancy; group A vs. group B, 10% vs. 42%; p = 0.03). The volume of rectosigmoid colon in the radiation field was significantly larger in group A (56.7 vs. 49.1 mL; p = 0.009). In dose volume histogram analysis, the mean irradiated volume was lower in patients in group B (V45 27.2 vs. 18.2 mL; p = 0.004). In Pearson correlation coefficient analysis, the in-field volume of rectosigmoid colon was significantly correlated with the bladder volume (R = 0.86, p = 0.003).

Conclusion: Use of a belly board and distended bladder protocol could contribute to exclusion of the proximal margin of anastomosis from the radiation field.

No MeSH data available.


Related in: MedlinePlus

Delineation of rectosigmoid colon on simulation computed tomography (orange, actual rectosigmoid colon delineated on axial slice; pink, modified delineation as a cylinder with 2-cm diameter).
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Figure 1: Delineation of rectosigmoid colon on simulation computed tomography (orange, actual rectosigmoid colon delineated on axial slice; pink, modified delineation as a cylinder with 2-cm diameter).

Mentions: Because the diameter of the rectosigmoid colon is significantly affected by bowel gas and/or feces, we assumed that the rectosigmoid colon is a cylinder of 2-cm diameter to calibrate differences in diameter. The rectosigmoid colon was delineated by a 2-cm diameter circle at each axial cut of the planning CT images from the level of the levator ani muscles to the level of the sacral promontory (Fig. 1). Thus, by measuring the volume of the cylinder, we could predict the volume of the rectosigmoid colon in the pelvic cavity.


Morphologic change of rectosigmoid colon using belly board and distended bladder protocol.

Cho Y, Chang JS, Kim MS, Lee J, Byun H, Kim N, Park SJ, Keum KC, Koom WS - Radiat Oncol J (2015)

Delineation of rectosigmoid colon on simulation computed tomography (orange, actual rectosigmoid colon delineated on axial slice; pink, modified delineation as a cylinder with 2-cm diameter).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493425&req=5

Figure 1: Delineation of rectosigmoid colon on simulation computed tomography (orange, actual rectosigmoid colon delineated on axial slice; pink, modified delineation as a cylinder with 2-cm diameter).
Mentions: Because the diameter of the rectosigmoid colon is significantly affected by bowel gas and/or feces, we assumed that the rectosigmoid colon is a cylinder of 2-cm diameter to calibrate differences in diameter. The rectosigmoid colon was delineated by a 2-cm diameter circle at each axial cut of the planning CT images from the level of the levator ani muscles to the level of the sacral promontory (Fig. 1). Thus, by measuring the volume of the cylinder, we could predict the volume of the rectosigmoid colon in the pelvic cavity.

Bottom Line: A total dose of 45 Gy was planned for the whole pelvic field with superior margin of the sacral promontory.The volume of rectosigmoid colon in the radiation field was significantly larger in group A (56.7 vs. 49.1 mL; p = 0.009).In dose volume histogram analysis, the mean irradiated volume was lower in patients in group B (V45 27.2 vs. 18.2 mL; p = 0.004).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, Korea.

ABSTRACT

Purpose: This study investigates morphologic change of the rectosigmoid colon using a belly board in prone position and distended bladder in patients with rectal cancer. We evaluate the possibility of excluding the proximal margin of anastomosis from the radiation field by straightening the rectosigmoid colon.

Materials and methods: Nineteen patients who received preoperative radiotherapy between 2006 and 2009 underwent simulation in a prone position (group A). These patients were compared to 19 patients treated using a belly board in prone position and a distended bladder protocol (group B). Rectosigmoid colon in the pelvic cavity was delineated on planning computed tomography (CT) images. A total dose of 45 Gy was planned for the whole pelvic field with superior margin of the sacral promontory. The volume and redundancy of rectosigmoid colon was assessed.

Results: Patients in group B had straighter rectosigmoid colons than those in group A (no redundancy; group A vs. group B, 10% vs. 42%; p = 0.03). The volume of rectosigmoid colon in the radiation field was significantly larger in group A (56.7 vs. 49.1 mL; p = 0.009). In dose volume histogram analysis, the mean irradiated volume was lower in patients in group B (V45 27.2 vs. 18.2 mL; p = 0.004). In Pearson correlation coefficient analysis, the in-field volume of rectosigmoid colon was significantly correlated with the bladder volume (R = 0.86, p = 0.003).

Conclusion: Use of a belly board and distended bladder protocol could contribute to exclusion of the proximal margin of anastomosis from the radiation field.

No MeSH data available.


Related in: MedlinePlus