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(PP163) A pilot study evaluating the prevention of abdominal adhesions via administration of beta radiation from a 90Sr/90Y applicator.
Rhoades, Samuel*,1, 2, Blough, Melissa1, 2, Hevezi, James1, 3, 1 Dept of Radiological Sciences, San Antonio, TX2 Dept of Medical Physics, San Antonio, TX3
ABSTRACT- In recent years, a resurgence in the use of 90Sr/90Y has occurred, primarily due to its use in intracoronary brachytherapy. 90Sr/90Y has also been employed in the ophthalmologic community for postoperative irradiation of pterygia. Due to these successes and other advantageous results of irradiating benign tumors and diseases, a new use for the 90Sr/90Y applicator has been hypothesized: the use of beta radiation for the prevention of abdominal adhesions. Adhesions are formed when the peritoneum suffers damage, releasing fibrin which accumulates on the injured surface. It is hypothesized that radiation could reduce the growth factor and prevent the development of adhesions. Preliminary measurements were made in a polystyrene phantom using GafChromic film and thermoluminescent dosimeters. Our results compared favorably with measured values for clinically relevant depths. We developed an equation to determine the dose deposited with depth. Our results compared favorably with measured values for clinically relevant depths. Upon completion of the phantom measurements, surgical and radiation protocols were developed. Two potential adhesion sites were created in the abdomen of Wistar rats via denudation of the serosa of the small intestine. Irradiation of one site with the 90Sr/90Y beta applicator occurred; the other site was used as a po sitive control keeping all parameters identical except for the application of radiation. A recovery period of 10 days followed, then the animals were euthanized and the injured areas analyzed for efficacy of treatment. Nine Sprague-Dawley rats were irradiated with doses of 20, 30, or 40 Gy to a prescription depth of 1mm. Gross and microscopic pathology was performed. Results show that radiation is effective in preventing adhesion formation. The sections of injured abdomen that received radiation had a much lower probability of forming adhesions (11% vs. 92%). Eight of nine irradiated sections showed no formation of adhesions, while the ninth developed one single adhesion. For the unirradiated sections, twelve of thirteen experienced adhesion formation. The Mann-Whitney U test was utilized for the matched pair data elicited from the research and a p-value of 0.022 was calculated, thus confirming the effectiveness of utilizing radiation to prevent adhesion formation.
Key words: brachytherapy, adhesions, abdomen, radiation
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