title: Systematic review of the role of a belly board device in radiotherapy delivery in patients with pelvic malignancies.
abstract: OBJECTIVE
  This review analyses the literature concerning the influence of the patient position (supine, prone and prone on a belly board device (BB) on the irradiated small-bowel-volume (SB-V)) and the resulting morbidity of radiation therapy (RT) in pelvic malignancies.
  
  
  METHODS
  A literature search was performed in MEDLINE, web of science and Scopus.
  
  
  RESULTS
  Forty-six full papers were found, of which 33 met the eligibility criteria. Fifteen articles focussed on the irradiated SB-V using dose volume histograms (DVHs). Twenty-seven articles studied the patient setup in different patient positions. This review showed that a prone treatment position can result in a lower irradiated SB-V as compared to a supine position, but a more significant reduction of the SB-V can be reached by the additional use of a BB in prone position, for both 3D-CRT and IMRT treatment plans. This reduction of the irradiated SB-V might result in a reduced GI-morbidity. The patient position did not influence the required PTV margins for prostate and rectum.
  
  
  CONCLUSIONS
  The irradiated SB-V can be maximally reduced by the use of a prone treatment position combined with a BB for both 3D-CRT and IMRT, which might individually result in a reduction of GI-morbidity.
authors.affiliation: Department of Radiation Oncology, University of Groningen, The Netherlands.
authors.forename: Esther M
authors.initials: EM
authors.lastname: Wiesendanger-Wittmer
authors.forename: Nanna M
authors.initials: NM
authors.lastname: Sijtsema
authors.forename: Christina T
authors.initials: CT
authors.lastname: Muijs
authors.forename: Jannet C
authors.initials: JC
authors.lastname: Beukema
mesh_terms: D006801:Humans; D007421:Intestine, Small / Q000528:radiation effects; D009017:Morbidity; D010386:Pelvic Neoplasms / Q000453:epidemiology / Q000532:radiotherapy*; D016684:Prone Position; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000295:instrumentation*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000295:instrumentation*; D016683:Supine Position