Three-port perineal sparing technique

Academic Article


  • 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 O 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.
  • Published In

  • Radiology  Journal
  • Digital Object Identifier (doi)

    Author List

  • Spencer SA; Pareek PN; Brezovich I; Larson BJ; Kim RY; Plott WG; Meredith RF; Smith JW; Weppelmann B; Soong SJ
  • Start Page

  • 563
  • End Page

  • 566
  • Volume

  • 180
  • Issue

  • 2