Abdominal pillow for the sparing of small bowel in four-field conventional pelvic radiotherapy

From 2003 through 2004, 88 patients with gynecological cancer were referred to Istanbul University Oncology Institute for pelvic radiation therapy. All patients underwent small bowel evaluation within the pelvic radiotherapy field in both the supine and prone positions with and without an abdominal pillow. The small bowel area included in radiation fields and intestinal movement were compared on PA films. All patients were treated by using the abdominal pillow. The median external beam pelvic radiation dose of 5040cGy (range. 3220-5400cGy) was administered. The mean distance of upward displacement of small bowel in the prone position on abdominal pillow compared with in the prone position alone and in the Supine position was 3.6 cm (range, 0-14 cm) and 4.7 cm (range. 0-14 cm). Using the abdominal pillow, the mean small bowel area was reduced by 45% and 55% compared to the prone position alone and the supine position, respectively (p = 0.0001). In patients who had pelvic surgery intestinal movement was significantly reduced. The incidence of G1, G2 and G3 acute radiation toxicity was 18%. 36% and 3%, respectively. This Study demonstrates that the small intestines can be displaced out of the radiation field by an abdominal pillow in the prone position. Also, this noninvasive technique provides for reduction Of acute gastrointestinal morbidity

The effects of simple and radical hysterectomy and radiotherapy on lower urinary tract symptoms and urodynamics

Purpose: To evaluate effects of simple/radical hysterectomy, radiotherapy, and their combination on lower urinary tract symptoms (LUTS) and urodynamics. Materials and Methods: Four groups were formed as simple hysterectomy; Group 1 (n = 20), Type-II hysterectomy; Group 2 (n = 11), Type-II hysterectomy + radiotherapy; Group 3 (n = 16), radiotherapy; Group 4 (n = 20). LUTS, bladder diary, pad test, Q-tip test, stress-test, urodynamics, bladder-wall-thickness measurement, King's Health Questionnaire (KHQ) performed prior and at six and 18 months after treatment. Results: Pre-treatment prevalence of LUTS was higher in Group 1 and decreased at six and 18 months. LUTS increased in Groups 2, 3, and 4 at six months; some of the symptoms decreased to pre-treatment levels at 18 months. Quality of life improved in Group 1 and worsened in the others. Maximum bladder capacity increased in Group 1 and decreased in Groups 2 and 3. Bladder-wall-thickness, maximum detrusor pressures increased, urine sensation decreased in Groups 2 and 4. Maximum vesical pressure increased and compliance decreased in Groups 2 and 3. Conclusion: LUTS may decrease after simple hysterectomy. Radical hysterectomy and radiotherapy result in voiding dysfunction; however some of the symptoms may decrease to pre-treatment levels during follow-up

Electrophysiological findings in patients who received radiation therapy over the brachial plexus: A magnetic stimulation study

Clinical and electrophysiological findings of 47 asymptomatic females who received radiation therapy (RT) over their brachial plexus region are presented and compared with 8 radiation-induced brachial plexopathy (REP) and 4 neoplastic brachial plexopathy (NBP) patients. In the asymptomatic group, abnormal findings were more frequent in patients whose post-RT period was longer than 1 year. Flexor carpi radialis H reflex was delayed or absent in 19 patients (52%) in this subgroup of asymptomatic cases, as compared to only 2 (18%) of the patients with post-RT periods of less than 1 year. Magnetic cervical nerve root stimulation was performed in 16 asymptomatic cases, with the conclusion that there was no significant difference between the irradiated and non-irradiated sides with regard to latencies, amplitudes and areas of the muscle responses. In spite of this, muscle response amplitudes and areas on both sides were significantly lower than those obtained from healthy controls. It was postulated that this finding resulted from hypoexcitability to magnetic stimulation produced by slight nerve root damage. Any part of the brachial plexus could be affected in REP and NBP patients. Myokymic discharges were found at a high rate (87.5%) in REP group. Cervical magnetic nerve root stimulation may have a diagnostic value in these patients in localizing the nerve lesion over the brachial plexus. Copyright (C) 1996 Elsevier Science Ireland Ltd

A comparison of body image, self-esteem and social support in total mastectomy and breast-conserving therapy in Turkish women.

As well as the medical outcomes of two distinct operations, namely total mastectomy and breast-conserving therapy, their impact on the psychic structuring of the patient may differ. A group of 40 woman with who had undergone mastectomy were therefore compared with another 40 with who had received breast-conserving therapy, with regard to the variables of body image, self-esteem and social support. The women who underwent breast-conserving therapy had a more positive body image (P0.05). A negative correlation was found between body image and social support (P<0.05). Patients with total mastectomy therefore do have a more negative body image than patients receiving breast-conserving therapy. Self-esteem and social support in the postoperative period in two groups are comparable