AbstractObjective To evaluate the effect of the bladder scanner upon maintaining the consistency of bladder filling in cervical cancer patients during the intensity-modulated radiotherapy. Methods The bladder volume change of 20 patients diagnosed with cervical cancer throughout radiotherapy were retrospectively analyzed to determine the timing of introducing the bladder scanner. Ten patients undergoing cervical cancer radiotherapy were selected to analyze the consistency between the bladder volume measured by bladder scanner and cone-beam CT (CBCT).The changes of bladder volume before and after the intervention of bladder scanner were statistically compared. Results In total,100 CBCT images of 20 patients were retrospectively analyzed. Nonparametric test demonstrated that the bladder volume significantly differed compared with the planning volume (P<0.05).Bland-Altman plot illustrated high consistency between the bladder volume measured by the bladder scanner and CBCT images with a mean difference of-6.66 cm3(95%CI:-53.1-39.83 cm3).Paired-t test showed there was statistical difference between the bladder volume before intervention and the planning bladder volume (P=0.000).The bladder volume after intervention did not significantly differ from the planning bladder volume (P=0.745). Conclusions The bladder volume significantly varies throughout the treatment process. Bladder scanner should be utilized prior to treatment. The bladder volume measured by the portable bladder scanner is consistent with the planning bladder volume.
Corresponding Authors:
Song Jianbo,Email:jianbo2611@126.com
Cite this article:
Lu Ying,Zhang Hailiang,An Junxuan et al. Consistency of bladder filling during intensity-modulated radiotherapy for cervical cancer[J]. Chinese Journal of Radiation Oncology, 2018, 27(9): 814-817.
Lu Ying,Zhang Hailiang,An Junxuan et al. Consistency of bladder filling during intensity-modulated radiotherapy for cervical cancer[J]. Chinese Journal of Radiation Oncology, 2018, 27(9): 814-817.
[1] Kaidar-Person O,Bortnyak-Abdah R,Amit A,et al. Current principles for radiotherapy in cervical cancer[J].Med Oncol,2012,29(4):2919-2922.DOI:10.1007/s12032-012-0170-7. [2] Jhingran A,Salehpour M,Sam M,et al. Vaginal motion and bladder and rectal volumes during pelvic intensity-modulated radiation therapy after hysterectomy[J].Int J Radiat Oncol Biol Phys,2012,82(1):256-262.DOI:10.1016/ j.ijrobp.2010.08.024. [3] 庞皓文,邱杰,全红,等.宫颈癌调强放疗中膀胱解剖结构变化及对其吸收剂量影响研究[J].中华放射肿瘤学杂志,2011,20(3):218-221.DOI:10.3760/cma.j.issn.1004-4221.2011.03.014. Pang HW,Qiu J,Quan H,et al. Bladder anatomical changes and dose variation during the course of intensity-modulated radiation therapy of cervical cancer[J].Chin J Radiat Oncol,2011,20(3):218-221.DOI:10.3760/cma.j.issn.1004-4221.2011.03.014. [4] Amer A,Marchant T,Sykes J,et al. Imaging doses from the Elekta Synergy X-ray cone beam CT system[J].Br J Radiol,2007,80(954):476-482.DOI:10.1259/bjr/80446730. [5] Al-Shaikh G,Larochelle A,Campbell CE,et al. Accuracy of bladder scanning in the assessment of postvoid residual volume[J].J Obstet Gynaecol Can,2009,31(6):526-532.DOI:10.1016/S1701-2163(16)34215-3. [6] 姜晓勃,钟庆初,黄群峰,等.盆腔肿瘤放疗中膀胱充盈一致性初步研究[J].中华放射肿瘤学杂志,2016,25(6):598-601.DOI:10.3760/cma.j.issn.1004-4221.2016.06.012. Jiang XB,Zhong QC,Huang QF,et al. Consistency of bladder filling during radiotherapy for pelvic tumor:a preliminary study[J].Chin J Radiat Oncol,2016,25(6):598-601.DOI:10.3760/cma.j.issn.1004-4221.2016.06.012. [7] 舒展,王悦,翟所迪.环磷酰胺致出血性膀胱炎的监测与防治[J].药物不良反应杂志,2006,8(4):269-272.DOI:10.3969/ j.issn.1008-5734.2006.04.009. Shu Z,Wang Y,Zhai SD.Cyclophosphamide-induced hemorrhagic cystitis:monitoring,prevention,and treatment[J].Adv Drug React J,2006,8(4):269-272.DOI:10.3969/j.issn.1008-5734.2006.04.009. [8] Ahmad R,Hoogeman MS,Bondar M,et al. Increasing treatment accuracy for cervical cancer patients using correlations between bladder-filling change and cervix-uterus displacements:proof of principle[J].Radiother Oncol,2011,98(3):340-346.DOI:10.1016/j.radonc.2010.11.010. [9] Luo,HL,Jin F,Yang DY,et al. Interfractional variation in bladder volume and its impact on cervical cancer radiotherapy:clinical significance of portable bladder scanner[J].Med Phys,2016,43(7):4412-4419.DOI:10.1118/ 1.4954206. [10] Jadon R,Pembroke CA,Hanna CL,et al. A systematic review of organ motion and image-guided strategies in external beam radiotherapy for cervical cancer[J].Clin Oncol,2014,26(4):185-196.DOI:10.1016/j.clon.2013.11.031. [11] 芦莹,宋建波.宫颈癌调强放疗中膀胱体积对摆位误差影响研究[J].实用医技杂志,2016,23(9):942-944. Lu Y,Song JB.Bladder volume changes and set-up error during the course of intensity-modulated radiation therapy of cervical cancer[J].J Pract Med Tech,2016,23(9):942-944. [12] 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. [13] 吴丽华,王颖,靳富,等.便捷式膀胱扫描仪在子宫颈癌放疗执行中的应用及其重要性[J].中国医学物理学杂志,2016,33(7):654-657.DOI:10.3969/j.issn.1005-202X.2016.07.002. Wu LH,Wang Y,Jin F,et al. Application and importance of portable bladder scanner in cervical cancer radiotherapy[J].Chin J Med Phys,2016,33(7):654-657.DOI:10.3969/j.issn.1005-202X.2016.07.002. [14] 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. [15] Eminowicz G,Rompokos V,Stacey C,et al. Understanding the impact of pelvic organ motion on dose delivered to target volumes during IMRT for cervical cancer[J].Radiother Oncol,2017,122(1):116-121.DOI:10.1016/j.radonc.2016.10.018.