High buttocks supine position to reduce small bowel exposure in gynecological radiotherapy.

Autor: Li C; College of Clinical Medicine for Oncology, Fujian Medical University, Fujian, China.; Department of Oncology, Second Hospital of Sanming City, Sanming, Fujian, China., Xiao YP; Department of Radiology, Fujian Medical University Cancer Hospital & Fujian Cancer Hospital, Fuzhou, China., Huang L; Department of Oncology, Second Hospital of Sanming City, Sanming, Fujian Province, China., Jing W; Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China., Zhang B; Department of Oncology, Second Hospital of Sanming City, Sanming, Fujian Province, China., Huang SH; Department of Oncology, Second Hospital of Sanming City, Sanming, Fujian Province, China., Yang LB; Department of Oncology, Second Hospital of Sanming City, Sanming, Fujian Province, China., Qiu SF; Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China. sufangqiu@fjmu.edu.cn.
Jazyk: angličtina
Zdroj: Radiation oncology (London, England) [Radiat Oncol] 2024 Sep 27; Vol. 19 (1), pp. 131. Date of Electronic Publication: 2024 Sep 27.
DOI: 10.1186/s13014-024-02522-6
Abstrakt: Purpose: To minimize radiation exposure to the small bowel (SB) in patients undergoing treatment for gynecological tumors by adopting a comfortable positioning method.
Methods and Patients: All 76 women undergoing Intensity-Modulated Radiation Therapy (IMRT) were included in this study. Patients were immobilized in a supine position using a vacuum bag and thermoplastic cast formation. In the trial group (n = 36), patients raised their buttocks and a solid foam pad was placed under the sacral tail before immobilization. The control group (n = 40) received treatment in the standard supine position. The SB was delineated from the pubic symphysis to the total iliac bifurcation in computed tomography (CT) scans.
Result: In the trial group, a significant reduction in SB volume within the pelvic cavity was observed (mean 399.17 ± 158.7 cc) compared to the control group (mean 547.48 ± 166.9 cc), with a p-value less than 0.001. The trial group showed a statistically significant reduction in the absolute volume of irradiated SB at each dose, ranging from the low dose (10 Gy) to the high dose (45 Gy). In the control group, a negative correlation was found between SB and bladder volumes (R = -0.411, P = 0.008), whereas in the trial group, this correlation was weaker (R = -0.286, P = 0.091), with no significant relationship observed between bladder volume and SB.
Conclusion: The high buttocks supine position effectively reduces SB radiation exposure without the need for bladder distension. This positioning method holds promise for reducing SB irradiation in various pelvic tumors.
(© 2024. The Author(s).)
Databáze: MEDLINE
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