Founded in 1993
  Year: 2002 | Volume: 10 | Issue: 1 | Pages: 13-17
  Original Article
  HDR BRACHYTHERAPY AND SUPERVOLTAGE EXTERNAL BEAM THERAPY OF CERVICAL CANCER: PROTECTION OF THE INTESTINAL TRACT DURING THE TREATMENT
Sasa LJUBENKOVIC
  DOI:
  Abstract:
  Background: During radiotherapy in most of the irradiated patients occur the symptoms of acute radiation enteritis, less frequently cystitis or proctitis. The aim of this work was to apply non-invasive exclusion methods to reduce the small bowel volume within the pelvic high dose volume and indirectly to reduce the number and severity of acute radiation enteritis.
Methods: A total number of 183 patients were enrolled in our prospective randomised investigation we performed at the Clinic of Oncology in Knez Selo during one year. Ninety patients from E-group were irradiated with the standard technique - two opposite parallel fields on the Mevatron-7445 linear accelerator (SIEMENS) patient-table, while 93 from C-group were irradiated under special conditions on our unique patient-table (PT) manufactured at our special demands by the Jugorendgen Ei-Nis factory. Brachytherapy was administered with RALT technique in both groups with isotope machine BUCHLER.
Results: Individual application of exclusion techniques led to protection of over 50% of the small bowel (118-1065 cm3) in 30/43 (70%) patients, and even in 10/43 (23%) more than 90% of the small bowel was protected (118-835 cm3), which would otherwise be irradiated with conventional techniques. None of the patients from E-group (out of 90) had more than 8 stools a day (G3), while in C-group there were 20 such cases. Seventy-seven percent of the patients from E-group had formed stool, while the percent in C-group was 29. In C-group 40% of the patients had so called "watery stools"; in E-group the percent was 4. Out of 53 patients from C-group with mobile small bowel, 21 (40%) had "watery diarrhoea".
Conclusion: Measures to prevent radiation enteritis should be taken before (surgical) or during (non-invasive) radiotherapy. At the Clinic of Oncology in Knez Selo, individual application of small bowel exclusion techniques using the unique patient-table (JUGORENDGEN Ei-Nis) led to protection of the small bowel during radiotherapy of uterine malignancies, which was reflected in a significantly reduced number and severity of acute enteritis symptoms.
  Key words: Cervix Neoplasms; Radiotherapy; Radiation Injuries; Enteritis
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Founder, owner and publisher: Oncology Institute of Vojvodina, Serbia
Online since 1997 (Abstracts only); 2000 (Abstracts and Full text)
ISSN: 0354-7310 eISSN: 1450-9520