Abstract： Objective To evaluate the feasibility of keeping the consistency of bladder filing by a Bladderscan (BS) device during radiotherapy for rectal cancer. Methods The bladder volume was measured using a BS device and recorded. To verify the reliability of the BS measurement, the urinary output was determined by a measuring glass after complete urinary discharge. The bladder volume of 42 patients determined by the planning computed tomography (CT) scans was used as the standard urinary volume. The bladder volume was measured using the BS device before radiotherapy every day. The chief complaint urinary volume was determined as the bladder volume when a patient felt a strong urge to urinate. The controlled urinary volume was determined as the urinary output intervened by the BS device to reach the standard urinary volume. Comparison was made by t test and data was assessed by Pearson correlation analysis. Results There was no significant difference in obtained urinary volume between the BS device and the planning CT scan (P=0.84). The urinary volume measured by the measuring glass was correlated with that measured by the BS device (P=0.00). The ability to hold urine in all patients was gradually weakened during treatment. The controlled urinary volume had a significantly smaller decrease after 1, 2, 3, 4, and 5 weeks of treatment than the chief complaint urinary volume (5% vs. 21%;6% vs. 20%;6% vs. 20%, 4% vs. 21%;11% vs. 26%;all P=0.00). Conclusions Patients have a gradually decreased urinary volume during treatment. The intervention by the BS device gives a bladder volume close to that in the planning system, which results in a consistent bladder filling.
Huang Qunfeng,Liu Jingdi,Liu Hui et al. Feasibility of keeping the consistency of bladder filling by a Bladderscan device during radiotherapy for rectal cancer[J]. Chinese Journal of Radiation Oncology, 2016, 25(10): 1088-1091.
[1] Sauer R,Becker H,Hohenberger W,et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer[J].New Engl J Med,2004,351(17):1731-1740.DOI:10.1056/ NEJMoa040694. [2] Kodner IJ,Shemesh EI,Fry RD,et al. Preoperative irradiation for rectal cancer. Improved local control and long-term survival[J].Ann Surg,1989,209(2):194-199. [3] Colorectal Cancer Collaborative Group. Adjuvant radiotherapy for rectal cancer:a systematic overview of 8,507 patients from 22 randomised trials[J].Lancet,2001,358(9290):1291-1304.DOI:10.1016/S0140-6736(01)06409-1. [4] Douglass HO,Moertel CG,Mayer RJ,et al. Survival after postoperative combination treatment of rectal cancer[J].New Engl J Med,1986,315(20):1294-1295.DOI:10.1056/NEJM198611133152014. [5] Kavanagh BD,Pan CC,Dawson LA,et al. Radiation dose-volume effects in the stomach and small bowel[J].Int J Radiat Oncol Biol Phys,2010,76(3 Suppl):S101-S107.DOI:10.1016/ j.ijrobp.2009.05.071. [6] Chang JS,Yoon HI,Cha HJ,et al. Bladder filling variations during concurrent chemotherapy and pelvic radiotherapy in rectal cancer patients:early experience of bladder volume assessment using ultrasound scanner[J].Radiat Oncol J,2013,31(1):41-47.DOI:10.3857/roj.2013.31.1.41. [7] Drzymala M,Hawkins MA,Henrys AJ,et al. The effect of treatment position,prone or supine,on dose-volume histograms for pelvic radiotherapy in patients with rectal cancer[J].Br J Radiol,2009,82(976):321-327.DOI:10.1259/bjr/57848689. [8] Nijkamp J,Doodeman B,Marijnen C,et al. Bowel exposure in rectal cancer IMRT using prone,supine,or a belly board[J].Radiother Oncol,2012,102(1):22-29.DOI:10.1016/j. radonc.2011.05.076. [9] Kim TH,Chie EK,Kim DY,et al. Comparison of the belly board device method and the distended bladder method for reducing irradiated small bowel volumes in preoperative radiotherapy of rectal cancer patients[J].Int J Radiat Oncol Biol Phys,2005,62(3):769-775.DOI:10.1016/j.ijrobp.2004.11.015. [10] Park W,Huh SJ,Lee J E,et al. Variation of small bowel sparing with small bowel displacement system according to the physiological status of the bladder during radiotherapy for cervical cancer[J].Gynecol Oncol,2006,99(3):645-651.DOI:10.1016/j.ygyno.2005.07.018. [11] Patra NB,Manir KS,Basu S,et al. Effect of bladder distension on dosimetry of organs at risk in computer tomography based planning of high-dose-rate intracavitary brachytherapy for cervical cancer[J].J Contemp Brachyther,2013,5(1):3-9.DOI:10.5114/jcb.2013.34339. [12] Mok H,Crane CH,Palmer MB,et al. Intensity modulated radiation therapy (IMRT):differences in target volumes and improvement in clinically relevant doses to small bowel in rectal carcinoma[J].Radiat Oncol,2011,6(1):63.DOI:10.1186/1748-717X-6-63. [13] Nakamura N,Shikama N,Takahashi O,et al. Variability in bladder volumes of full bladders in definitive radiotherapy for cases of localized prostate cancer[J].Strahlenther Onkol,2010,186(11):637-642.DOI:10.1007/s00066-010-2105-6. [14] Ahmad R,Hoogeman MS,Quint S,et al. Inter-fraction bladder filling variations and time trends for cervical cancer patients assessed with a portable 3-dimensional ultrasound bladder scanner[J].Radiother Oncol,2008,89(2):172-179.DOI:10.1016/j.radonc.2008.07.005. [15] Stam MR,van Lin ENJT,van der Vight LP,et al. Bladder filling variation during radiation treatment of prostate cancer:can the use of a bladder ultrasound scanner and biofeedback optimize bladder filling?[J].Int J Radiat Oncol Biol Phys,2006,65(2):371-377.DOI:10.1016/j. ijrobp.2005.12.039. [16] Kim RY,Shen S,Lin HY,et al. Effects of bladder distension on organs at risk in 3D image-based planning of intracavitary brachytherapy for cervical cancer[J].Int J Radiat Oncol Biol Phys,2010,76(2):485-489.DOI:10.1016/j.ijrobp.2009.02.002. [17] Zhang HQ,Wang RB,Yan HJ,et al. Influence of bladder distension control on postoperative intensity-modulated radiotherapy in rectal cancer patients[J].Asian Pac J Cancer Prev,2011,12(11):2969-2972. [18] 何玉香,蔡勇,朱向高,等.直肠癌盆腔放疗后肠受照射影响因素的研究[J].中华放射医学与防护杂志,2007,27(5):482-485.DOI:10.3760/cma.j.issn.0254-5098.2007.05.021. He YX,Cai Y,Zhu XG,et al. Analysis of influence factors on the volume of pelvic bowel irradiated for rectal cancer[J].Chin J Radiol Med Prot,2007,27(5):482-485.DOI:10.3760/cma.j.issn.0254-5098.2007.05.021. [19] Jain S,Loblaw DA,Morton GC,et al. The effect of radiation technique and bladder filling on the acute toxicity of pelvic radiotherapy for localized high risk prostate cancer[J].Radiother Oncol,2012,105(2):193-197.DOI:10.1016/j.radonc.2012.09.020. [20] Fiorino C,Foppiano F,Franzone P,et al. Rectal and bladder motion during conformal radiotherapy after radical prostatectomy[J].Radiother Oncol,2005,74(2):187-195.DOI:10.1016/j.radonc.2004.10.002. [21] Antolak JA,Rosen Ⅱ,Childress CH,et al. Prostate target volume variations during a course of radiotherapy[J].Int J Radiat Oncol Biol Phys,1998,42(3):661-672.DOI:10.1016/S0360-3016(98)00248-X.
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