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How can the aetiological factors of rectal distension be managed to reduce interfraction prostate motion during a course of radiotherapy treatment

Published online by Cambridge University Press:  28 September 2015

Helen Bayles ,
Mark Collins  and
Melanie Clarkson
Helen Bayles*
Affiliation:
Radiotherapy Outpatient Department, The James Cook University Hospital, Middlesbrough, ClevelandUK
Mark Collins
Affiliation:
Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
Melanie Clarkson
Affiliation:
Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
*
Correspondence to: Helen Bayles, Radiotherapy Outpatient Department, The James Cook University Hospital, Marton Road, Middlesbrough, Cleveland TS4 3BW, UK. Tel: +0 164 285 0850 ext 54277; E-mail: helen.bayles@stees.nhs.uk
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Abstract

Aim

During radiotherapy of the prostate it is important to minimise interfraction prostate motion to allow dose escalation and reduce normal tissue damage. Rectal volume has been identified as playing a significant role in prostate motion with various methods used to reduce it. The aim was to systematically review published literature to allow evidence based recommendations to be made to current practice to reduce interfraction prostate motion.

Materials and methods

A systematic search of CINAHL, Medline, PubMed, Science Direct, NHS Evidence and The Cochrane Library was performed. Limited searches of The Society of Radiographers website, OpenGrey and COPAC were undertaken, alongside manual searches of cross references of eligible articles. The quality of included papers was measured using a pre-existing tool. The causes, consequences and solutions to manage rectal volume and its effect on prostate position were extracted, compared and evaluated to extract solutions to be implemented into clinical practice.

Results

Of the 2,339 unique articles systematically retrieved, 23 met the inclusion criteria, 15 of which discuss radiotherapy, five constipation and three flatulence.

Findings

A combined medicinal and dietary approach adaptable to departmental workflow is required to manage rectal volume, with special consideration to patients with pre-existing extrinsic factors.

Keywords

bowel gasinterfraction motionprostateradiotherapyrectal distensionrectal volume
Type
Literature Review
Information
Journal of Radiotherapy in Practice , Volume 15 , Issue 1 , March 2016 , pp. 76 - 84
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Copyright
© Cambridge University Press 2015 

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