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KMID : 0357520130360010039
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Journal of Radiological Science and Technology
2013 Volume.36 No. 1 p.39 ~ p.47
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The Effect of Obesity Levels on Irradiated Small Bowel volume in Belly Board with Small Bowel Displacement Device Method for Rectal Cancer Radiotherapy
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Kim Se-Young
Kim Joo-Ho
Park Hyo-Kuk
Cho Jung-Heui
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Abstract
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For radiotherapy in rectal cancer patients treated with small bowel displacement device (SBDD) and belly board, We will suggest new indication of using SBDD depending on obesity index by analyzing correlation between obesity and irradiated small bowel volume. In this study, We reviewed 29 rectal cancer patients who received pelvic radiation therapy with belly board and SBDD from January to April in 2012. We only analyzed those patients treated with three-field technique (PA and both LAT) on 45 Gy (1.8 Gy/fx). We measured patients height, weight, body mass index (BMI), waist-hip ratio (WHR) and divided BMI into two groups.(${geq}23$ 수식 이미지:BMI=group1, <23:BMI=group2) We performed a statistical analysis to evaluate correlation between total volume of bladder($TV_{bladder}$ 수식 이미지), obesity index and high dose volume of small bowel (small bowel volume irradiated at 90% of prescribed dose,$HDV_{sb}$ 수식 이미지 ), low dose volume of small bowel (small bowel volume irradiated at 33% of prescribed dose,$LDV_{sb}$ 수식 이미지 ). The result shows, gender, WHR and status of pre operative or post operative do not greatly affect $HDV_{sb}$ 수식 이미지 and$LDV_{sb}$ 수식 이미지 . Statistical result shows, there are significant correlation between $HDV_{sb}$ 수식 이미지 and BMI (p<0.04), $HDV_{sb}$ 수식 이미지 and $TV_{bladder}$ 수식 이미지 (p<0.01), $LDV_{sb}$ 수식 이미지 and $TV_{bladder}$ 수식 이미지 (p<0.01). BMI seems to correlate with $HDV_{sb}$ 수식 이미지 but does not with $LDV_{sb}$ 수식 이미지 (p>0.05). There are negative correlation between $HDV_{sb}$ 수식 이미지 and BMI, $TV_{bladder}$ 수식 이미지 and$HDV_{sb}$ 수식 이미지 ,$TV_{bladder}$ 수식 이미지 and$LDV_{sb}$ 수식 이미지 . Especially, BMI group1 has more effective and negative correlation with $HDV_{sb}$ 수식 이미지 (p=0.027) than in BMI group2. In the case of BMI group 1, $TV_{bladder}$ 수식 이미지 has significant negative correlation with $HDV_{sb}$ 수식 이미지 and $LDV_{sb}$ 수식 이미지 (p<0.04). In conclusions, we confirmed that Using SBDD with belly board in BMI group1 could more effectively reduce irradiated small bowel volume in radiation therapy for rectal cancer. Therefore, We suggest using belly board with SBDD in order to reduce the small bowel toxicity in rectal radiotherapy, if patients BMI is above 23.
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KEYWORD
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belly board, SBDD, BMI, irradiated small bowel volume, small bowel toxicity
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