Efficacy of a belly board device with CT-simulation in reducing small bowel volume within pelvic irradiation fields

Indra J. Das, Rachelle M. Lanciano, Benjamin Movsas, Kazufumi Kagawa, Scott J. Barnes

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

Purpose/Objective: Acute and chronic small bowel toxicity associated with pelvic irradiation limits dose escalation for both chemotherapy and radiotherapy for rectal cancer. Various surgical and technical maneuvers including compression and belly board devices (BBD) have been used to reduce small bowel volume in treatment fields. However, quantitative dose volume advantages of such methods have not been reported. In this study, the efficacy of BBD with CT-simulation is presented with dose-volume histogram (DVH) analyses for rectal cancer. Methods and Materials: Twelve consecutive patients referred to our department with rectal cancer were included in this study. Patients were given oral contrast 1.5 h prior to scanning and instructed not to empty their bladder during the procedure. The initial CT scan without BBD was taken in the prone position with an immobilization cast. A second CT study was performed with a commercially available BBD consisting of an 18-cm thick hard sponge with an adjustable opening (maximum 42 x 42 cm2). All patients were positioned prone over the BBD so that the opening was above the treatment volume and usually extended from the diaphragm to the bottom of the fourth lumbar spine. Image fusion between both sets of CT scans (with and without BBD) was performed using common bony landmarks to maintain the same target volume. The critical structures including small bowel and bladder were delineated on each slice for DVH analysis. On each study, a three-field optimized plan with conformal blocks in beams-eye-view was generated for volumetric analysis. The DVHs with and without BBD were evaluated for each patient. Results: The median age and body weight of 12 patients (4 females and 8 males) were 57.5 years and 82.7 kg, respectively. The changes in posterior-anterior (PA) and lateral separation with and without BBD at central axis slices were analyzed. The changes in lateral separation were minimal (

Original languageEnglish (US)
Pages (from-to)67-76
Number of pages10
JournalInternational Journal of Radiation Oncology Biology Physics
Volume39
Issue number1
DOIs
StatePublished - Aug 1 1997
Externally publishedYes

Fingerprint

Equipment and Supplies
irradiation
Rectal Neoplasms
simulation
dosage
bladder
cancer
histograms
Urinary Bladder
volumetric analysis
prone position
body weight
Prone Position
landmarks
spine
maneuvers
Porifera
diaphragms
chemotherapy
Diaphragm

Keywords

  • Belly-board device
  • CT-simulation
  • Rectal cancer
  • Small bowel toxicity

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Efficacy of a belly board device with CT-simulation in reducing small bowel volume within pelvic irradiation fields. / Das, Indra J.; Lanciano, Rachelle M.; Movsas, Benjamin; Kagawa, Kazufumi; Barnes, Scott J.

In: International Journal of Radiation Oncology Biology Physics, Vol. 39, No. 1, 01.08.1997, p. 67-76.

Research output: Contribution to journalArticle

Das, Indra J. ; Lanciano, Rachelle M. ; Movsas, Benjamin ; Kagawa, Kazufumi ; Barnes, Scott J. / Efficacy of a belly board device with CT-simulation in reducing small bowel volume within pelvic irradiation fields. In: International Journal of Radiation Oncology Biology Physics. 1997 ; Vol. 39, No. 1. pp. 67-76.
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