A comprehensive systematic literature review regarding the challenges encountered with obese patients during external photon beam radiotherapy treatment planning and delivery

Abstract

Background: Obesity poses additional challenges during both the planning and delivery of external photon beam radiotherapy (EPBRT) treatment. These challenges affect the overall treatment experience of the patients, could potentially lead to adverse side effects and a compromised clinical outcome, and also impact the radiotherapy staff. Objectives: The objectives of the study were: (a) To present a comprehensive systematic analysis of the main challenges encountered during EPBRT treatment planning and delivery, due to obesity. (b) To present any similarities and/or differences in the challenges encountered due to obesity during EPBRT treatment of different cancer sites. (c) To present any major side effects experienced by obese patients during/after EPBRT treatment. (d) To briefly present the clinical outcome of EPBRT treatment in obese patients. Research methodology: Since it was deduced that the objectives of the study were best attained through an exploratory research design, a qualitative research approach was adopted. A systematic search strategy was used to identify relevant literature from a number of electronic search engines and research databases, and a comprehensive systematic analysis was then conducted to collect data from the included literature. Results: The findings of the study highlighted the encounter of several challenges during EPBRT treatment of obese patients. These challenges were associated particularly with patient positioning, imaging, and/or treatment planning, and varied upon consideration of different cancer sites, specifically, the endometrium, cervix, breast, prostate, and oesophagus. Additionally, the challenges in question often negatively impacted the prevalence of side effects as well as the clinical outcome associated with the aforementioned cancer sites. Conclusions and recommendations: All the objectives of the study were sufficiently met. However, it is recommended that a broader literature review which analyses a larger number of texts, is conducted to explore notable points which were not discussed in any of the texts analysed in this study.