Prone Positioning on a Belly Board Decreases Rectal and Bowel Doses in Pelvic Intensity-Modulated Radiation Therapy (IMRT) for Prostate Cancer

Renáta Kószó, Linda Varga, Emese Fodor, Z. Kahán, Adrienne Cserháti, K. Hideghéty, Zsófia Együd, Csilla Szabó, Emőke Borzási, Dorottya Szabó, Kitti Müllner, Zoltán Varga, Anikó Maráz

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The presence of normal tissues in the irradiated volume limits dose escalation during pelvic radiotherapy (RT) for prostate cancer. Supine and prone positions on a belly board were compared by analyzing the exposure of organs at risk (OARs) using intensity modulated RT (IMRT). The prospective trial included 55 high risk, localized or locally advanced prostate cancer patients, receiving definitive image-guided RT. Computed tomography scanning for irradiation planning was carried out in both positions. Gross tumor volume, clinical and planning target volumes (PTV) and OARs were delineated, defining subprostatic and periprostatic rectal subsegments. At the height of the largest antero-posterior (AP) diameter of the prostate, rectal diameters and distance from the posterior prostate wall were measured. IMRT plans were generated. Normal tissue exposure and structure volumes were compared between supine and prone plans using paired t-test. In the volumes of the prostate, PTV, colon and small bowel, no significant differences were found. In prone position, all rectal volumes, diameters, and rectum–prostate distance were significantly higher, the irradiated colon and small bowel volume was lower in dose ranges of 20–40 Gy, and the exposure to all rectal segments was more favorable in 40–75 Gy dose ranges. No significant difference was found in the exposure of other OARs. Prone positioning on a belly board is an appropriate positioning method aiming rectum and bowel protection during pelvic IMRT of prostate cancer. The relative reduction in rectal exposure might be a consequence of the slight departure between the prostate and rectal wall.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalPathology and Oncology Research
DOIs
Publication statusAccepted/In press - Jun 7 2018

Fingerprint

Organs at Risk
Prostate
Prostatic Neoplasms
Radiotherapy
Prone Position
Colon
Image-Guided Radiotherapy
Intensity-Modulated Radiotherapy
Supine Position
Tumor Burden
Rectum
Tomography

Keywords

  • Belly board
  • IMRT
  • Prone
  • Prostate cancer
  • Rectum
  • Small bowel

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Oncology
  • Cancer Research

Cite this

Prone Positioning on a Belly Board Decreases Rectal and Bowel Doses in Pelvic Intensity-Modulated Radiation Therapy (IMRT) for Prostate Cancer. / Kószó, Renáta; Varga, Linda; Fodor, Emese; Kahán, Z.; Cserháti, Adrienne; Hideghéty, K.; Együd, Zsófia; Szabó, Csilla; Borzási, Emőke; Szabó, Dorottya; Müllner, Kitti; Varga, Zoltán; Maráz, Anikó.

In: Pathology and Oncology Research, 07.06.2018, p. 1-8.

Research output: Contribution to journalArticle

Kószó, Renáta ; Varga, Linda ; Fodor, Emese ; Kahán, Z. ; Cserháti, Adrienne ; Hideghéty, K. ; Együd, Zsófia ; Szabó, Csilla ; Borzási, Emőke ; Szabó, Dorottya ; Müllner, Kitti ; Varga, Zoltán ; Maráz, Anikó. / Prone Positioning on a Belly Board Decreases Rectal and Bowel Doses in Pelvic Intensity-Modulated Radiation Therapy (IMRT) for Prostate Cancer. In: Pathology and Oncology Research. 2018 ; pp. 1-8.
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abstract = "The presence of normal tissues in the irradiated volume limits dose escalation during pelvic radiotherapy (RT) for prostate cancer. Supine and prone positions on a belly board were compared by analyzing the exposure of organs at risk (OARs) using intensity modulated RT (IMRT). The prospective trial included 55 high risk, localized or locally advanced prostate cancer patients, receiving definitive image-guided RT. Computed tomography scanning for irradiation planning was carried out in both positions. Gross tumor volume, clinical and planning target volumes (PTV) and OARs were delineated, defining subprostatic and periprostatic rectal subsegments. At the height of the largest antero-posterior (AP) diameter of the prostate, rectal diameters and distance from the posterior prostate wall were measured. IMRT plans were generated. Normal tissue exposure and structure volumes were compared between supine and prone plans using paired t-test. In the volumes of the prostate, PTV, colon and small bowel, no significant differences were found. In prone position, all rectal volumes, diameters, and rectum–prostate distance were significantly higher, the irradiated colon and small bowel volume was lower in dose ranges of 20–40 Gy, and the exposure to all rectal segments was more favorable in 40–75 Gy dose ranges. No significant difference was found in the exposure of other OARs. Prone positioning on a belly board is an appropriate positioning method aiming rectum and bowel protection during pelvic IMRT of prostate cancer. The relative reduction in rectal exposure might be a consequence of the slight departure between the prostate and rectal wall.",
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AU - Cserháti, Adrienne

AU - Hideghéty, K.

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AU - Borzási, Emőke

AU - Szabó, Dorottya

AU - Müllner, Kitti

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