Kim Tae Hyun, Kim Dae Yong, Cho Kwan Ho, Kim Young Hoon, Jung Kyung Hae, Ahn Joong-Bae, Chang Hee Jin, Kim Joo-Young, Choi Hyo Seong, Lim Seok-Byung, Sohn Dae Kyung, Jeong Seung-Yong
Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea.
Strahlenther Onkol. 2005 Sep;181(9):601-5. doi: 10.1007/s00066-005-1398-3.
To compare the effect of reducing the irradiated small-bowel volume with the use of belly board, bladder distension or both methods combined, in patients with rectal cancer undergoing postoperative pelvic radiotherapy.
This study enrolled 20 consecutive patients with rectal cancer who were scheduled to receive postoperative pelvic radiotherapy. All patients underwent four sets of CT scans under four different methods as follows: group I: empty bladder without the use of a belly board; group II: empty bladder with the use of a belly board; group III: bladder distension without the use of a belly board; group IV: bladder distension with the use of a belly board. The conventional three-field treatment plan was made using a three-dimensional treatment planning system. The irradiated small-bowel volume was calculated at 10% intervals from 10% to 100% of the prescribed dose.
The volume of the irradiated small bowel decreased in the order of group I, group II, group III, and group IV at all dose levels (p < 0.001). In comparison to group I, the mean absolute volume reductions (relative volume reduction) of the irradiated small bowel were 41.5 +/- 20.1 cm(3) (33.9 +/- 12.9%) in group II, 76.6 +/- 30.5 cm(3) (55.1 +/- 17.8%) in group III, and 98.5 +/- 36.7 cm(3) (70.7 +/- 14.5%) in group IV.
Bladder distension was a more effective method than the belly board for reducing the irradiated small-bowel volume in postoperative pelvic radiotherapy of rectal cancer patients. The combination of the belly board and bladder distension showed an additive effect and was the most effective method for reducing the irradiated small-bowel volume.
比较在接受术后盆腔放疗的直肠癌患者中，使用腹板、膀胱充盈或两者联合使用来减少小肠受照射体积的效果。
本研究纳入了20例计划接受术后盆腔放疗的直肠癌患者。所有患者在以下四种不同方法下接受四组CT扫描：第一组：膀胱排空且不使用腹板；第二组：膀胱排空且使用腹板；第三组：膀胱充盈且不使用腹板；第四组：膀胱充盈且使用腹板。使用三维治疗计划系统制定常规的三野治疗计划。在规定剂量的10%至100%之间，以10%的间隔计算小肠受照射体积。
在所有剂量水平下，小肠受照射体积按第一组、第二组、第三组和第四组的顺序递减（p < 0.001）。与第一组相比，第二组小肠受照射的平均绝对体积减少量（相对体积减少量）为41.5 +/- 20.1 cm³（33.9 +/- 12.9%），第三组为76.6 +/- 30.5 cm³（55.1 +/- 17.8%），第四组为98.5 +/- 36.7 cm³（70.7 +/- 14.5%）。
在直肠癌患者术后盆腔放疗中，膀胱充盈比腹板是更有效的减少小肠受照射体积的方法。腹板和膀胱充盈联合使用显示出相加效应，是减少小肠受照射体积最有效的方法。
