Evaluation of a Simple Belly-Board Device for Reduction of Small Bowel Inside Rectal Cancer Radiotherapy Fields

Abstract

Background: We evaluated the efficacy of a simple belly-board device (BBD) designed and made in our department for reduction of small bowel inside the post-operative pelvic radiotherapy fields of rectal carcinomas. Methods: A very simple BBD was designed and manufactured in our department. It was made of acrylic glass, and was 128 cm long, 40 cm wide, and 9 cm high, with a 25x25 cm square opening, the lower border of which was set to be positioned about 3 cm above patients’ iliac crest. Patients to be treated post-operatively for rectal cancers were simulated using oral contrast with and without the BBD for postero-anterior (PA) and lateral fields. The small bowel surface area (SBSA) inside the fields was measured and compared in the films with and without the BBD. Results: Twenty-one patients, mean age 56 years, male-to-female ratio 2:1, 12 abdominoperineal (APR) and 9 low anterior resection (LAR), gave consent for this study. The mean SBSA were 7 and 13 cm2 in the lateral fields and 29 and 60 cm2 in the PA fields with and without the BBD, respectively (p = 0.001). The mean reduction in SBSA was 61% in the lateral fields, 53% in the PA fields, and 57% in both lateral and PA fields (p<0.001). The mean reduction in SBSA in lateral fields was 77% after LAR and 49% after APR (p=0.08). This difference was not significant for PA fields. The only factor with a significant effect was operation type (LAR versus APR) for reduction of SBSA in lateral fields (p=0.05). Gender, age, body mass index, and field sizes did not have a significant effect. Conclusion: The simple BBD could significantly reduce the SBSA inside the pelvic radiotherapy fields of rectal cancers. This reduction seems more pronounced after LAR in the lateral fields, compared to APR.

Keywords

• Breast cancer
• radiotherapy