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KMID : 0859320080260040271
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Journal of the Korean Society for Therapeutic Radiology and Oncology
2008 Volume.26 No. 4 p.271 ~ p.279
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The 3-Dimensional Analysis of the Efficacy of a Belly-Board Device ofr the Displacement of Small Bowel During Pelvic Irradiation
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Lee Kyung-Ja
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Abstract
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Purpose: To evaluate the efficacy of a belly-board device (BBD) in reducing the volume of small bowel during
four-field pelvic irradiation.
Materials and Methods: Twenty-two cancer patients (14 uterine cervical cancer, 6 rectal cancer, and 2
endometrial cancer) scheduled to receive pelvic irradiation were selected for this study. Two sets of CT images
were taken with and without the belly-board device using the Siemens 16 channel CT scanner. All patients were
set in the prone position. The CT images were transferred to a treatment planning system for dose calculation
and volume measurements. The external surfaces of small bowel and the bladder were contoured on all CT
scans and the 4-pelvic fields were added. The dose-volume-histogram of the bladder and small bowel, with
and without the BBD, were plotted and analyzed.
Results: In all patients, the total small bowel volume included in the irradiated fields was reduced when the BBD
was used. The mean volume reduction was 35% (range, 1∼79%) and was statistically significant (p＜0.001).
The reduction in small bowel volume receiving 10∼100% of the prescribed dose was statistically significant
when the BBD was used in all cases. Almost no change in the total bladder volume involved was observed in
the field (＜8 cc, p=0.762). However, the bladder volume receiving 90% of the prescribed dose was 100% in
15/22 patients (68%) and 90∼99% in 7/22 patients (32%) with the BBD. In comparison, the bladder volume
receiving 90% of the prescribed dose was 100% in 10/22 patients (45%), 90∼99% in 7/22 patients (32%), and
80∼89% in 5/22 patients (23%) without the BBD. When the BBD was used, an increase in the bladder volume
receiving a high dose range was observed
Conclusion: This study shows that the use of a BBD for the treatment of cancer in the pelvic area significantly
improves small bowel sparing. However, since the BBD pushed the bladder into the treatment field, the bladder
volume receiving the high dose could increase. Therefore it is recommended to be considerate in using the BBD
when bladder damage is of concern.
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KEYWORD
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Belly-board device, Small bowel volume, Radiation therapy
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