A critical literature review on the use of bellyboard devices to control small bowel dose for pelvic radiotherapy.

Delivering curative radiotherapy doses for rectal and gynaecological tumours has historically been complicated by the dose tolerance of the small bowel. Acute radiation-induced small bowel toxicity includes side effects such as abdominal pain, nausea and diarrhoea. With the advent of new treatment delivery modalities, such as IMRT (Intensity modulated radiotherapy) and VMAT (Volumetric modulated Arc radiotherapy), there has been an expectation that small bowel doses can be better controlled with the use of these technologies. These capabilities enable the creation of treatment plans that can better avoid critical radiosensitive organs. The purpose of this review is to look beyond advances in linear accelerator technology in seeking improvements to small bowel dose and toxicity. This review examines whether an alternative prone patient positioning approach using a bellyboard device in conjunction with IMRT and VMAT treatment delivery can reduce small bowel doses further than using these technologies with the patient in a traditional supine position.

Unintended pregnancy rates among a US military population.

Unintended pregnancy among military women influences their lives and has implications for troop readiness and deployment. The purpose of this study was to identify the prevalence of unintended pregnancy in the US Army and assess the variables associated with unintended pregnancy. Using a cross-sectional design, 212 female soldiers who delivered viable infants at Darnall Army Community Hospital, Fort Hood, Texas from 1 June 1998 to 6 October 1998 completed a self-administered survey on pregnancy intention and sociodemographic factors. Approximately 35% of the infants were intended, 51% were unintended and 14% were ambivalent, resulting in 65% not intended, a rate consistent with the upper level of civilian communities. Factors associated univariably with unintended pregnancy included being unmarried, being in the lower enlisted rank, having less than a college degree, and living in the barracks. This study shows the importance of developing programmes and policies that address pregnancy among military personnel.

Information on chemotherapy and hormone therapy from tumor registry had moderate agreement with chart reviews.

BACKGROUND: Surveillance, Epidemiology, and End Results (SEER) cancer registries provide accurate information on cancer surgery and radiation, but the validity of registry data on chemotherapy and hormone therapy for breast cancer has not been well studied. We validated the registry data for chemotherapy and hormone therapy against an independent medical chart review. METHODS: We identified 1,228 women diagnosed with breast cancer at age > or = 65 in 1993-1999 in the New Mexico SEER Tumor Registry and completed medical chart reviews. RESULTS: Overall, there was moderate agreement between these two databases on chemotherapy that was received within 6 months of diagnosis. The observed agreement was 96.0%, with a kappa of 0.72 (95% confidence interval: 0.64-0.79). The sensitivity of the registry data for chemotherapy was 70.7% and the specificity was 98.2%. The positive predictive value of the registry data for chemotherapy was 77.8%. The sensitivity of the registry data for hormone therapy was 59.7%, and the specificity was 89.5%. The observed agreement for hormone therapy was 80.0%, with a kappa of 0.52 (0.46-0.57). CONCLUSION: Agreement on chemotherapy and hormone therapy between the New Mexico SEER Tumor Registry and chart reviews was moderate. The preferred approach would be to combine data from different sources to obtain more complete information.