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Conformal radiotherapy in oncologic gynecology – requirements and pitfalls

Barbara Kozakiewicz1, Anna Semaniak1, Małgorzata Chądzyńska2

Affiliacja i adres do korespondencji
CURR. GYNECOL. ONCOL. 2009, 7 (4), p. 256-263
Streszczenie

Radiotherapy implemented in the treatment of patients with female genital malignancies consists in fractionated irradiation of the patients in the same therapeutic position, lasting for 4 to 6 weeks. Currently used conformal techniques with intense dose modulation (intensity modulated radiation therapy, IMRT) precisely define treated area and critical organs located within. This paper explores the difference in volume of treated and protected areas in patients with cervical cancer and endometrial cancer placed prone for radiotherapy in a belly board BBD support, as compared with traditional positions used to date, i.e. supine or prone position BBD support. Treatment plans were elaborated for 20 patients for these three therapeutic positions and treated and protected areas were compared. Analysis revealed that only obese patients (BMI>27) in prone position with BBD support had smaller volume of irradiated bowel as compared with prone position without support (p=0.049), and particularly with supine position (p=0.008). Other patients with normal BMI value or slim persons did not benefit from the use of BBD support. After an at least 24 months’ long follow-up we monitored the incidence of radiation-induced reactions among patients using the BBD support and persons irradiated according to the same conformal technique but placed prone without BBD support. The study revealed that the incidence and severity of radiation-induced reaction in both groups of patients were similar.

Słowa kluczowe
belly board BBD, conformal technique in gynecology, radiotherapy for cervical and endometrial cancer, BMI of irradiated patients, radiation-induced reaction