Department of Radiation Oncology, University of Groningen, The Netherlands.
Radiother Oncol. 2012 Mar;102(3):325-34. doi: 10.1016/j.radonc.2012.02.004. Epub 2012 Feb 22.
This review analyses the literature concerning the influence of the patient position (supine, prone and prone on a belly board device (BB) on the irradiated small-bowel-volume (SB-V)) and the resulting morbidity of radiation therapy (RT) in pelvic malignancies.
A literature search was performed in MEDLINE, web of science and Scopus.
Forty-six full papers were found, of which 33 met the eligibility criteria. Fifteen articles focussed on the irradiated SB-V using dose volume histograms (DVHs). Twenty-seven articles studied the patient setup in different patient positions. This review showed that a prone treatment position can result in a lower irradiated SB-V as compared to a supine position, but a more significant reduction of the SB-V can be reached by the additional use of a BB in prone position, for both 3D-CRT and IMRT treatment plans. This reduction of the irradiated SB-V might result in a reduced GI-morbidity. The patient position did not influence the required PTV margins for prostate and rectum.
The irradiated SB-V can be maximally reduced by the use of a prone treatment position combined with a BB for both 3D-CRT and IMRT, which might individually result in a reduction of GI-morbidity.
本综述分析了患者体位（仰卧位、俯卧位和俯卧位在腹部垫板装置上）对盆腔恶性肿瘤放射治疗（RT）中照射小肠体积（SB-V）的影响及其导致的发病率的文献。
在 MEDLINE、web of science 和 Scopus 中进行了文献检索。
共发现 46 篇全文，其中 33 篇符合入选标准。15 篇文章使用剂量体积直方图（DVH）研究了照射的 SB-V。27 篇文章研究了不同患者体位下的患者设置。本综述表明，与仰卧位相比，俯卧位治疗可导致照射的 SB-V 降低，但在俯卧位时额外使用腹部垫板可使 SB-V 显著降低，无论是 3D-CRT 还是 IMRT 治疗计划。照射 SB-V 的减少可能会导致胃肠道发病率降低。患者体位不影响前列腺和直肠的 PTV 边缘。
使用俯卧治疗体位结合腹部垫板可最大程度地减少照射的 SB-V，无论是 3D-CRT 还是 IMRT，这可能会单独降低胃肠道发病率。
