title: Three-port perineal sparing technique.
abstract: The records were reviewed of 103 patients with low-lying pelvic malignancies irradiated with a skin-sparing technique involving use of a pair of anteroposterior-posteroanterior opposed ports and a direct perineal port. Patients had rectal, anal, cervical, vaginal, urethral, or vulvar cancer. Use of a special lead compensator allowed the three beams to be applied perpendicularly to the surface, while delivery of a homogeneous dose to the pelvis and perineum was maintained. Skin dose with this method was greatly reduced compared with that delivered with simple opposing or four-port techniques, in which irradiation is tangential to the surface at the perineum. Acute perineal skin irritation was assigned a grade between 0 and 3, with grade 0 representing the least amount of irritation. All patients were in the grade 0 or grade 1 category. Patients treated for low-lying rectal carcinoma showed no increase in perineal recurrences when compared with historic control subjects. Use of this approach allowed delivery of adequate doses to the pelvis and perineum and a definite decrease in local toxic effects, and local control was not compromised.
authors.affiliation: Department of Radiation Oncology, University of Alabama in Birmingham 35223.
authors.forename: S A
authors.initials: SA
authors.lastname: Spencer
authors.forename: P N
authors.initials: PN
authors.lastname: Pareek
authors.forename: I
authors.initials: I
authors.lastname: Brezovich
authors.forename: B J
authors.initials: BJ
authors.lastname: Larson
authors.forename: R Y
authors.initials: RY
authors.lastname: Kim
authors.forename: W G
authors.initials: WG
authors.lastname: Plott
authors.forename: R F
authors.initials: RF
authors.lastname: Meredith
authors.forename: J W
authors.initials: JW
authors.lastname: Smith
authors.forename: B
authors.initials: B
authors.lastname: Weppelmann
authors.forename: S J
authors.initials: SJ
authors.lastname: Soong
mesh_terms: D000230:Adenocarcinoma / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D006119:Groin; D006801:Humans; D007854:Lead; D008198:Lymph Nodes / Q000528:radiation effects; D008297:Male; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000532:radiotherapy*; D010502:Perineum / Q000528:radiation effects*; D011835:Radiation Protection / Q000295:instrumentation / Q000379:methods*; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000532:radiotherapy; D012189:Retrospective Studies; D012867:Skin / Q000528:radiation effects
chemical_list: D007854:Lead