The Impact of Patient Positioning
and belly board use on small bowel
in Patients receiving Pre-operative
radiotherapy for rectal cancer:
a Prospective Phase ii study

(1) * GEZ ELIAHU• (1) TEMPELHOF HAIM• (1) SOIFER VIACHESLAV (1) • MATCHEYVSKY DIANA
• (1) SHACHAM SHMUELI EINAT • (1) SHPIGEL SHULIM • (1) RAVIT GEVA RAVIT (1) CORN W BEN

Introduction

The optimal positioning for patients receiving pelvic radiotherapy remains controversial. Among the most important considerations is the effect of the treatment position on the small intestine’s exposure to radiation. This study considered this problem in the context of patients receiving pre-operative, conformal pelvic irradiation for rectal cancer

Introduction

The optimal positioning for patients receiving pelvic radiotherapy remains controversial. Among the most important considerations is the effect of the treatment position on the small intestine’s exposure to radiation. This study considered this problem in the context of patients receiving pre-operative, conformal pelvic irradiation for rectal cancer

Patients / Methods

Ten patients with rectal cancer stage II & III underwent CT-simulations in both the prone and supine positions with or without belly board utilization, respectively. Two plans were generated for each position using 3 & 4 field’s technique (i.e., 4 treatment plans total). Treatment consisted of pelvic irradiation, 4,500cGy, followed by a 540 cGy boost to the rectum combined with 5FU-based chemotherapy

Introduction

The optimal positioning for patients receiving pelvic radiotherapy remains controversial. Among the most important considerations is the effect of the treatment position on the small intestine’s exposure to radiation. This study considered this problem in the context of patients receiving pre-operative, conformal pelvic irradiation for rectal cancer

Results

The median of the mean radiation dose to the small bowel in supine-3-field vs. prone-3-field was 2,925 vs. 2,337cGy (p=0.03), in supine- 4-field vs.prone-4-field was 3,066 vs. 2,607cGy (p=0.01), in supine3-field vs. 4 supine-4-field was 2,925 vs. 3.066cGy (p=0.07) and in prone 3-field vs. 4-fields was 2,337 vs. 2,607cGy (p=.0.17). The difference in the D50 of the small bowel between the positions was not statistically significant

Introduction

The optimal positioning for patients receiving pelvic radiotherapy remains controversial. Among the most important considerations is the effect of the treatment position on the small intestine’s exposure to radiation. This study considered this problem in the context of patients receiving pre-operative, conformal pelvic irradiation for rectal cancer

Conclusions

The prone position with belly board in patients receiving pelvis radiotherapy for rectal cancer minimized the radiation dose to the small intestine. Therefore, the use of a belly board in the prone position should be considered for patients who can tolerate this accessory in this position