Sebastià Sabater1, Ignacio Andrés2, Marina Gascon3, Angeles Rovirosa4, Marimar Sevillano2, Roberto Berenguer2, Cristina Camacho-Lopez4, Manuel Aguayo2, Maria Victoria Villas2, Meritxell Arenas3. 1. Department of Radiation Oncology, Complejo Hospitalario Universitario de Albacete (CHUA), C/Hnos Falcó 37, 02006, Albacete, Spain. ssabaterm@gmail.com. 2. Department of Radiation Oncology, Complejo Hospitalario Universitario de Albacete (CHUA), C/Hnos Falcó 37, 02006, Albacete, Spain. 3. Department of Radiation Oncology, Hospital Universitari Sant Joan, Reus, Spain. 4. Gynecological Cancer Unit, Radiation Oncology Department, ICMHO, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain.
Abstract
PURPOSE: To evaluate the effects of rectal enemas on rectal doses during postoperative high-dose-rate (HDR) vaginal cuff brachytherapy (VCB). PATIENTS AND METHODS: This prospective trial included 59 patients. Two rectal cleansing enemas were self-administered before the second fraction, and fraction 1 was considered the basal status. Dose-volume histogram (DVH) values were generated for the rectum and correlated with rectal volume variation. Statistical analyses used paired and unpaired t-tests. RESULTS: Despite a significant 15 % reduction in mean rectal volume (44.07 vs. 52.15 cc, p = 0.0018), 35.6 % of patients had larger rectums after rectal enemas. No significant rectal enema-related DVH differences were observed compared to the basal data. Although not statistically significant, rectal cleansing-associated increases in mean rectal DVH values were observed: D0.1 cc: 6.6 vs. 7.21 Gy; D1 cc: 5.35 vs. 5.52 Gy; D2 cc: 4.67 vs. 4.72 Gy, before and after rectal cleaning, respectively (where Dx cc is the dose to the most exposed x cm(3)). No differences were observed in DVH parameters according to rectal volume increase or decrease after the enema. Patients whose rectal volume increased also had significantly larger DVH parameters, except for D5 %, D25 %, and D50 %. In contrast, in patients whose rectal volume decreased, significance was only seen for D25 % and D50 % (Dx % dose covering x % of the volume). In the latter patients, nonsignificant reductions in D2 cc, D5 cc and V5 Gy (volume receiving at least 5 Gy) were observed. CONCLUSION: The current rectal enemas protocol was ineffective in significantly modifying rectal DVH parameters for HDR-VCB.
PURPOSE: To evaluate the effects of rectal enemas on rectal doses during postoperative high-dose-rate (HDR) vaginal cuff brachytherapy (VCB). PATIENTS AND METHODS: This prospective trial included 59 patients. Two rectal cleansing enemas were self-administered before the second fraction, and fraction 1 was considered the basal status. Dose-volume histogram (DVH) values were generated for the rectum and correlated with rectal volume variation. Statistical analyses used paired and unpaired t-tests. RESULTS: Despite a significant 15 % reduction in mean rectal volume (44.07 vs. 52.15 cc, p = 0.0018), 35.6 % of patients had larger rectums after rectal enemas. No significant rectal enema-related DVH differences were observed compared to the basal data. Although not statistically significant, rectal cleansing-associated increases in mean rectal DVH values were observed: D0.1 cc: 6.6 vs. 7.21 Gy; D1 cc: 5.35 vs. 5.52 Gy; D2 cc: 4.67 vs. 4.72 Gy, before and after rectal cleaning, respectively (where Dx cc is the dose to the most exposed x cm(3)). No differences were observed in DVH parameters according to rectal volume increase or decrease after the enema. Patients whose rectal volume increased also had significantly larger DVH parameters, except for D5 %, D25 %, and D50 %. In contrast, in patients whose rectal volume decreased, significance was only seen for D25 % and D50 % (Dx % dose covering x % of the volume). In the latter patients, nonsignificant reductions in D2 cc, D5 cc and V5 Gy (volume receiving at least 5 Gy) were observed. CONCLUSION: The current rectal enemas protocol was ineffective in significantly modifying rectal DVH parameters for HDR-VCB.
Authors: S Sabater; Ma M Sevillano; I Andres; R Berenguer; S Machin-Hamalainen; K Müller; M Arenas Journal: Strahlenther Onkol Date: 2013-09-04 Impact factor: 3.621
Authors: Giuseppe Iatì; Antonio Pontoriero; Stefania Mondello; Anna Brogna; Andrea Di Pasquale; Isidora Ielo; Antonio Potami; Giovanna Messina; Costantino De Renzis; Stefano Pergolizzi Journal: Brachytherapy Date: 2014-06-27 Impact factor: 2.362
Authors: William Small; Sushil Beriwal; D Jeffrey Demanes; Kathryn E Dusenbery; Patricia Eifel; Beth Erickson; Ellen Jones; Jason J Rownd; Jennifer F De Los Santos; Akila N Viswanathan; David Gaffney Journal: Brachytherapy Date: 2012 Jan-Feb Impact factor: 2.362
Authors: Raquel Dávila Fajardo; Rob van Os; Marrije R Buist; Lon Uitterhoeve; Anneke M Westermann; Gemma G Kenter; Coen R N Rasch; Lukas J A Stalpers Journal: Gynecol Oncol Date: 2014-04-29 Impact factor: 5.482
Authors: Jihoon Lim; Blythe Durbin-Johnson; Richard Valicenti; Matthew Mathai; Robin L Stern; Jyoti Mayadev Journal: Int J Gynecol Cancer Date: 2013-07 Impact factor: 3.437
Authors: I Valduvieco; Á Rovirosa; A Herreros; I Romera; I Ríos; C Ascaso; A Sánchez-Reyes; M Arenas; J Pahisa; A Biete Journal: Clin Transl Oncol Date: 2012-12-21 Impact factor: 3.405
Authors: Katarzyna Sikorska; Agnieszka Zolciak-Siwinska; Adam Kowalczyk; Michał Bijok; Wojciech Michalski; Ewelina Gruszczynska Journal: J Contemp Brachytherapy Date: 2020-06-30