A study of stability training and reliability of bladder filling before radiotherapy for pelvic tumors
Muyasha·Abulimiti,Zhou Weibing,Liu Haifeng,Zhu Hong
Department of Radiation Oncology,Xiangya Hospital of Central South University,Changsha 410008,China (Muyasha·A,Zhou WB,Liu HF,Zhu H);Xinjiang Medical University,Wulumuqi 830000,ChinaZhu Hong,Email:zhuhong0719@126.com
Abstract:Objective To explore the reliability of patients’ sensation of the need to urinate,and to investigate the optimal volume and duration of bladder filling and training method for the stability of bladder filling. Methods From 2014 to 2015,Fifty patients with pelvic tumor were divided into group A and group B,according to whether they had the history of diseases or surgery in the pelvis or urinary system. Both groups received training of the sensation of the need to urinate. The training required patients to drink a fixed volume of water every time they emptied the bladder. The bladder capacity was measured by a bladder scanner (BladderScan BVI 9400),and a rating scale of the sensation of the need to urinate was completed at 30 min,45 min,1 h,and over 1 h when the patient sensed the limit for bladder capacity. The optimal volume and duration of bladder filling or optimal frequency for the training were explored. The paired t-test method was performed for the difference between the predictive value and the measured value,Pearson method was performed for correlation between the sensation of the need to urinate and the measured value. Results In the A and B groups,there was no significant difference between the predicted value and measured value (A:predicted value and measured value P=0.777,B:predicted value and measured value P=0.061),suggesting that the measured value could be used to reflect the predictive value. Compared with group B,group A had a higher correlation between the sensation of the need to urinate and the measured value (rA=0.812,rB=0.762).The correlation between the predictive value and the measured value became the highest at 45 min and 1 h (r=0.858 and 0.916),and the corresponding bladder filling volume and score of the sensation of the need to urinate were 330-450 ml and 4-6,respectively. The correlation between the predictive value and the measured value increased with the frequency of the training (r2=0.914,r3=0.917,r4=0.930,r5=0.951,r6=0.962). Conclusions Before radiotherapy,patients with pelvic tumor should received at least 4-6 rounds of the training of bladder filling. Patients should drink 800-1400 ml of water every time they empty the bladder,and the optimal bladder filling volume and the reliable and stable sensation of the need to urinate will be achieved after 45 min-1 h. For the patients with the history of urinary system diseases or pelvic surgery,the bladder filling volume needs to be measured using a bladder scanner (BladderScan BVI 9400) during the training before radiotherapy.
Muyasha·Abulimiti,Zhou Weibing,Liu Haifeng et al. A study of stability training and reliability of bladder filling before radiotherapy for pelvic tumors[J]. Chinese Journal of Radiation Oncology, 2016, 25(2): 146-154.
[1]殷蔚伯,余子豪,徐国镇,等.肿瘤放射治疗学[M].4版.北京:中国协和医科大学出版社,2008. Yin WB,Yu ZH,Xu GZ,et al. Radiation oncology[M].4th ed. Beijing:Peking Union Medical College Press,2008. [2]綦向.图像引导下的宫颈癌自适应调强放射治疗[J].中医临床研究,2014,6(27):139-141.DOI:10.3969/j.issn.1674-7860.2014.27.059.Qi X.Image-guided adaptive radiation therapy of intensity-modulated radiation for cervical cancer[J].Clin J Chin Med,2014,6(27):139-141.DOI:10.3969/j.issn.1674-7860.2014.27.059. [3]Simpson DR,Song WY,Moiseenko V,et al. Normal tissue complication probability analysis of acute gastrointestinal toxicity in cervical cancer patients undergoing intensity modulated radiation therapy and concurrent cisplatin[J].Int J Radiat Oncol Biol Phys,2012,83(1):e81-e86.DOI:10.1016/j.ijrobp.2011.12.012. [4]Hynds S,McGarry C,Mitchell DM,et al. Assessing the daily consistency of bladder filling using an ultrasonic bladders can device in men receiving radical conformal radiotherapy for prostate cancer[J].Br J Radiol,2011,84(1005):813-818.DOI:10.1259/bjr/50048151. [5]王锐濠,张书旭,林生趣.肿瘤精确放疗新进展——图像引导自适应放疗[J].中国医学物理学杂志,2012,29(4):3467-3471.DOI:10.3969/j.issn.1005-202X.2012.04.002. Wang RH,Zhang SX,Lin SQ.New advance of precise radiotherapy:image-guided adaptive radiation therapy[J].Chin J Med Phys,2012,29(4):3467-3471.DOI:10.3969/j.issn.1005-202X.2012.04.002. [6]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 Prey,2011,12(11):2969-2972.