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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

Mean irradiated volumes of rectosigmoid colon per 5-Gy dose increment for both groups.
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Figure 3: Mean irradiated volumes of rectosigmoid colon per 5-Gy dose increment for both groups.

Mentions: A greater number of patients in group B, who were treated using belly board and distended bladder protocol, had a visually straightened rectosigmoid colon compared with group A (no redundancy; group A vs. group B, 10% vs. 42%; p = 0.03). Table 2 shows comparisons of morphology as determined by the redundancy and volume of the rectosigmoid colon in the pelvic cavity. The volume of the rectosigmoid colon was significantly larger in group A (56.7 vs. 49.1 mL; p = 0.009). The number of redundancies was relatively high in group A compared with group B, but did not show statistical significance (p = 0.06). Fig. 3 shows the mean irradiated volumes of rectosigmoid colon in both groups per 5-Gy dose increment. The volume of irradiated rectosigmoid colon was significantly lower for patients in group B at all dose levels, and this difference was more significant at a higher dose (V45; 27.2 vs. 18.2 mL; p = 0.004).


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)

Mean irradiated volumes of rectosigmoid colon per 5-Gy dose increment for both groups.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Mean irradiated volumes of rectosigmoid colon per 5-Gy dose increment for both groups.
Mentions: A greater number of patients in group B, who were treated using belly board and distended bladder protocol, had a visually straightened rectosigmoid colon compared with group A (no redundancy; group A vs. group B, 10% vs. 42%; p = 0.03). Table 2 shows comparisons of morphology as determined by the redundancy and volume of the rectosigmoid colon in the pelvic cavity. The volume of the rectosigmoid colon was significantly larger in group A (56.7 vs. 49.1 mL; p = 0.009). The number of redundancies was relatively high in group A compared with group B, but did not show statistical significance (p = 0.06). Fig. 3 shows the mean irradiated volumes of rectosigmoid colon in both groups per 5-Gy dose increment. The volume of irradiated rectosigmoid colon was significantly lower for patients in group B at all dose levels, and this difference was more significant at a higher dose (V45; 27.2 vs. 18.2 mL; p = 0.004).

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