EVALUATION OF DIFFERENT METHODS TO MINIMIMIZE SMALL BOWEL TOXICITY FROM PELVIC IRRADIATION FOR PELVIC MALIGNANCIES
REHAM ABO EL-MONIEM MOHAMED;
Abstract
Background and purpose Pelvic radiation is associated with acute and long-tenn toxicity. Complications of pelvic radiation therapy are a function of the volume, the radiation field, overall treatment time, fraction size, total dose, and technique. Surgeons and radiotherapists have tried to solve this by developing different methods to exclude the intestine from the pelvis during radiotherapy. Which are optimization of radiotherapy techniques and special surgical techniques. Material and methods GROUP I includes 40 cancer rectum patients treated by external irradiation using two different treatment planning techniques, a closed and open table top techniques. GROUP II includes 5 patients followed up after surgery and omentoplasty using barium follow through at different time intervals to evaluate the degree of sagging of small intestine in the true pelvis.
Results The estimated small bowel volume differs in closed and open table
technique significantly with p value < 0.001. There is significant difference between the CT and the simulator based method of estimating the small bowel volume in the closed table technique only p _value < 0.036. The nausea and vomiting significantly decreased with the use of the open table technique p value < 0.03. Diarrhea significantly decreased in open table technique with p value< 0.001. The small bowel chronic complications did not differ significantly with the technique p value 0.56. There is evident descent of the small bowel into the pelvis after 1 month following surgery with p value< 0.006.
Conclusion The open table technique with prone position is associated with reduction of the small bowel volume and acute GIT toxicity during pelvic irradiation in comparison to closed table technique. Omentoplasty is a surgical technique aiming at reducing the small bowel descent in the pelvic cavity, but the number of patients was small for proper evaluation.
Key wards radiotherapy techniques- open table technique- closed table technique- omentoplasty- belly board device
Results The estimated small bowel volume differs in closed and open table
technique significantly with p value < 0.001. There is significant difference between the CT and the simulator based method of estimating the small bowel volume in the closed table technique only p _value < 0.036. The nausea and vomiting significantly decreased with the use of the open table technique p value < 0.03. Diarrhea significantly decreased in open table technique with p value< 0.001. The small bowel chronic complications did not differ significantly with the technique p value 0.56. There is evident descent of the small bowel into the pelvis after 1 month following surgery with p value< 0.006.
Conclusion The open table technique with prone position is associated with reduction of the small bowel volume and acute GIT toxicity during pelvic irradiation in comparison to closed table technique. Omentoplasty is a surgical technique aiming at reducing the small bowel descent in the pelvic cavity, but the number of patients was small for proper evaluation.
Key wards radiotherapy techniques- open table technique- closed table technique- omentoplasty- belly board device
Other data
| Title | EVALUATION OF DIFFERENT METHODS TO MINIMIMIZE SMALL BOWEL TOXICITY FROM PELVIC IRRADIATION FOR PELVIC MALIGNANCIES | Other Titles | تقييم الطرق المختلفة لتقليل الاعراض الجانبية للامعاء الدقيقة أثناء تشعيع الحوض فى أورام الحوض | Authors | REHAM ABO EL-MONIEM MOHAMED | Issue Date | 2000 |
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