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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

Assessment of redundancy by relating morphologic changes on the digitally reconstructed radiography images. Patients were subsequently divided into four groups: (A) no redundancy, (B) 1 redundancy, (C) 2 redundancies, (D) ≥3 redundancies.
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Figure 2: Assessment of redundancy by relating morphologic changes on the digitally reconstructed radiography images. Patients were subsequently divided into four groups: (A) no redundancy, (B) 1 redundancy, (C) 2 redundancies, (D) ≥3 redundancies.

Mentions: One radiation oncologist contoured the bladder and rectosigmoid colon on the simulation CT image and calculated their volumes. The rectosigmoid colon was assessed for redundancy by relating the morphologic changes on the digitally reconstructed radiography (DRR) images. Patients were subsequently divided into four groups: no redundancy, 1 redundancy, 2 redundancies, and 3 or more redundancies (Fig. 2).


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)

Assessment of redundancy by relating morphologic changes on the digitally reconstructed radiography images. Patients were subsequently divided into four groups: (A) no redundancy, (B) 1 redundancy, (C) 2 redundancies, (D) ≥3 redundancies.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Assessment of redundancy by relating morphologic changes on the digitally reconstructed radiography images. Patients were subsequently divided into four groups: (A) no redundancy, (B) 1 redundancy, (C) 2 redundancies, (D) ≥3 redundancies.
Mentions: One radiation oncologist contoured the bladder and rectosigmoid colon on the simulation CT image and calculated their volumes. The rectosigmoid colon was assessed for redundancy by relating the morphologic changes on the digitally reconstructed radiography (DRR) images. Patients were subsequently divided into four groups: no redundancy, 1 redundancy, 2 redundancies, and 3 or more redundancies (Fig. 2).

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