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- W2023272934 abstract "Patients treated with radiotherapy for rectal cancer at SRCC, are generally treated prone with a full bladder, to limit the volume of small bowel in the high dose region. This protocol has been adapted from facilities that position patients prone on a belly board device, allowing the patient's belly and small bowel, to fall anterior out of the high dose region. In the absence of a belly board, several studies have shown that treating prone compared to supine has limited benefit in terms of reducing small bowel exposure. Furthermore, the setup is less reproducible between and during fractions. It has been hypothesized that this effect on reproducibility is due to patient discomfort in the prone position. For this retrospective study, our study population consisted of patients treated between January 2011 to September 2013 (n=37), with a radiation prescription of 50 Gy in 25 fractions, both supine (n=8), if an ostomy was in situ, and prone (n=29) positions. The dosimetric differences to small bowel when positioning patients in prone without a belly board versus supine were analyzed. Furthermore, reproducibility of positioning was reviewed by plotting image guided shifts in both positions. Preliminary results showed no statistically significant differences between supine and prone in V15 (p=0.41) and V45 (p=0.40) for the small bowel. However, the standard deviation of the supine population is smaller than the prone population. In addition, a smaller initial setup error from the daily CBCT was noted in patients positioned supine. A mean shift of 5.2 mm in the anterior to posterior plane for prone positioning versus 1.5 mm for supine positioning, in this study population. Patient positioning appears more reproducible in the supine position, and there is no statistically significant difference in doses to organs at risk in the study population. However, given that our current protocol is to position all rectum patients prone, unless contra-indicated, the sample size for the supine position is small. Correspondingly, the patients positioned supine, are a biased sample (mainly ostomy patients). Furthermore, the datasets are all independent, thus not accounting for differences in individual patient anatomy." @default.
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- W2023272934 date "2014-06-01" @default.
- W2023272934 modified "2023-09-26" @default.
- W2023272934 title "Supine vs. Prone: A Retrospective Study on Rectum Patient Positioning" @default.
- W2023272934 doi "https://doi.org/10.1016/j.jmir.2014.03.056" @default.
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