Which bowel preparation is best? Comparison of a high-fibre diet leaflet, daily microenema and no preparation in prostate cancer patients treated with radical radiotherapy to assess the effect on planned target volume shifts due to rectal distension
| Autor: | S. Yahya, A. Zarkar, G Webster, E. Southgate, P Nightingale |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Dietary Fiber
Male Cone beam computed tomography medicine.medical_specialty medicine.medical_treatment Rectum Enema Prostate cancer Prostate Medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Prospective cohort study Radiation Injuries Aged Anatomy Cross-Sectional Full Paper business.industry Radiotherapy Planning Computer-Assisted Prostatic Neoplasms General Medicine Organ Size Cone-Beam Computed Tomography Middle Aged medicine.disease medicine.anatomical_structure Cohort Rectal distension Radiology business Dilatation Pathologic |
| Zdroj: | The British journal of radiology. 86(1031) |
| ISSN: | 1748-880X |
| Popis: | We evaluated and compared a high-fibre diet leaflet, daily microenema and no preparation to establish how best to achieve consistent bowel preparation in prostate cancer patients being treated with radical radiotherapy.3 cohorts of 10 patients had different dietary interventions: no bowel preparation, high-fibre diet information leaflet and daily microenemas. The available cone beam CT (CBCT) scans of each patient were used to quantify interfractional changes in rectal distension (measured using average cross-sectional area-CSA), prostate shifts relative to bony anatomy compared with that at CT planning scan and rates of geometric miss (i.e. shifts of ≥5 mm). 85 CBCT scans were available in the pre-leaflet cohort, 89 scans in the post-leaflet, and 89 scans in the post-enema group.Mean rectal CSA in the post-enema group was reduced compared with both pre-leaflet (p=0.010) and post-leaflet values (p=0.031). The magnitude of observed mean prostate shifts was significantly reduced in the post-enema group compared with the pre-leaflet group (p=0.014). The proportion of scans showing geometric miss (i.e. shift5 mm) in the post-enema group (31%) was significantly lower than in the pre-leaflet (62%, p0.001) or post-leaflet groups (56%, p0.001).This study indicates microenema to be an effective measure to achieve reduction in rectal CSA, prostate shift and reduce geometric miss of ≥5 mm. A further prospective randomised study is advocated to validate the results.The use of microenema is effective in reducing prostate shift and rectal CSA, consequently decreasing the incidence of geographical miss. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|