Less to Hold – a Comparison of Bowel and Bladder Toxicities in Patients Undergoing Prostate Radiotherapy between those Treated with an Empty Bladder and those Following a Bladder Filling Protocol

2019 ◽  
Vol 31 (2) ◽  
pp. e23
Author(s):  
S. Morrison ◽  
T. Ellis ◽  
E. Fillingham ◽  
Y.P. Song ◽  
A. Birtle
Keyword(s):  
Prostate Radiotherapy ◽  
Bladder Filling ◽  
Empty Bladder

scholarly journals BladderScan Feedback Method in Predicting Bladder Filling for Prostate Radiotherapy: A Prospective Study

2021 ◽  
Vol 20 ◽  
pp. 153303382199527
Author(s):  
Deng-Yu Kuo ◽  
Chen-Yang Hsu ◽  
Wei-Chun Wang ◽  
Hsiu-Hsi Chen ◽  
Pei-Wei Shueng
Keyword(s):  
Prostate Cancer ◽  
Failure Rate ◽  
Conventional Method ◽  
Bladder Volume ◽  
Relative Reduction ◽  
Radiation Cystitis ◽  
Prostate Radiotherapy ◽  
Bladder Filling ◽  
Feedback Method ◽  
A Prospective Study

Purpose: Approximately 5%–10% of men who receive prostate cancer radiotherapy will suffer from radiation cystitis. Bladder filling before the administration of radiotherapy results in lower radiation exposure to the bladder. BladderScan, an ultrasound-based bladder volume scanner, has the potential to evaluate bladder volume during radiotherapy; thus, a prospective pilot study was initiated. Methods: Eleven men receiving tomotherapy for localized prostate cancer were enrolled. The validity of BladderScan was evaluated by comparing the measurements from BladderScan with the calculated volume from megavoltage computed tomography (MVCT). With a crossover design to compare different methods in bladder filling, the radiotherapy was divided into 2 sequences. Conventional method: the patient was asked to drink water after voiding urine. The amount of water and the duration of waiting were the same as in the setting of the simulation. BladderScan feedback method: the bladder filling procedure depended on the BladderScan measurements. Results: There were 314 sets of data from 11 patients. The correlation coefficient between VBS and VCT was 0.87, where VBS is the mean volume of 3 measurements by BladderScan and VCT is the bladder volume derived from MVCT. The BladderScan feedback method resulted in a significant larger bladder volume than the conventional method, with a mean difference of 36.9 mL. When the failure was defined as VCT <80% of planned volume, the BladderScan feedback method brought about a relative reduction in the failure rate with an odds ratio of 0.44 and an absolute reduction of 9.1%. Conclusion: The accuracy of BladderScan was validated by MVCT in our study. The BladderScan feedback method can help patients fill the bladder adequately, with a larger bladder volume and a lower failure rate.

scholarly journals Overview of patient preparation strategies to manage internal organ motion during radiotherapy in the pelvis

2019 ◽  
Vol 19 (2) ◽  
pp. 182-189
Author(s):  
F. Slevin ◽  
M. Beasley ◽  
R. Speight ◽  
J. Lilley ◽  
L. Murray ◽  
...  
Keyword(s):  
Image Guidance ◽  
Conformal Radiotherapy ◽  
Pelvic Organ ◽  
Organ Motion ◽  
High Quality ◽  
Prostate Radiotherapy ◽  
Bladder Filling ◽  
Full Bladder ◽  
Patient Preparation ◽  
Belly Board

AbstractIntroduction:Pelvic internal organs change in volume and position during radiotherapy. This may compromise the efficacy of treatment or worsen its toxicity. There may be limitations to fully correcting these changes using online image guidance; therefore, effective and consistent patient preparation and positioning remain important. This review aims to provide an overview of the extent of pelvic organ motion and strategies to manage this motion.Methods and Materials:Given the breadth of this topic, a systematic review was not undertaken. Instead, existing systematic reviews and individual high-quality studies addressing strategies to manage pelvic organ motion have been discussed. Suggested levels of evidence and grades of recommendation for each strategy have been applied.Results:Various strategies to manage rectal changes have been investigated including diet and laxatives, enemas and rectal emptying tubes and rectal displacement with endorectal balloons (ERBs) and rectal spacers. Bladder-filling protocols and bladder ultrasound have been used to try to standardise bladder volume. Positioning the patient supine, using a full bladder and positioning prone with or without a belly board, has been examined in an attempt to reduce the volume of irradiated small bowel. Some randomised trials have been performed, with evidence to support the use of ERBs, rectal spacers, bladder-filling protocols and the supine over prone position in prostate radiotherapy. However, there was a lack of consistent high-quality evidence that would be applicable to different disease sites within the pelvis. Many studies included small numbers of patients were non-randomised, used less conformal radiotherapy techniques or did not report clinical outcomes such as toxicity.Conclusions:There is uncertainty as to the clinical benefit of many of the commonly adopted interventions to minimise pelvic organ motion. Given this and the limitations in online image guidance compensation, further investigation of adaptive radiotherapy strategies is required.

scholarly journals EP-2173 Bladder filling in patients undergoing prostate radiotherapy on the MR-linac

2019 ◽  
Vol 133 ◽  
pp. S1200-S1201
Author(s):  
G. Adair Smith ◽  
T. Herbert ◽  
R. Lawes ◽  
H. Creasey ◽  
A. Dunlop ◽  
...  
Keyword(s):  
Prostate Radiotherapy ◽  
Bladder Filling

scholarly journals The implementation of an empty bladder filling protocol for localised prostate volumetric modulated arctherapy (VMAT): early results of a single institution service evaluation

2020 ◽  
Vol 93 (1114) ◽  
pp. 20200548
Author(s):  
Gayan Chetiyawardana ◽  
Peter J. Hoskin ◽  
Yat Man Tsang
Keyword(s):  
Prostate Cancer ◽  
Treatment Time ◽  
External Beam ◽  
Bladder Filling ◽  
Full Bladder ◽  
Early Results ◽  
Gu Toxicity ◽  
The Impact ◽  
Empty Bladder

Objective: To examine the impact of an empty bladder filling protocol on patients receiving radical RT for localised prostate cancer on post RT toxicity and biochemical progression free survival (bPFS). Methods and materials: Records of patients receiving radical external beam RT (EBRT) for localised prostate cancer with a full or empty bladder were reviewed. These included the bladder size on planning CT, daily online image guided RT (IGRT) setup data, treatment time and post treatment follow up data.These included bPFS, gastrointestinal(GI) and genitourinary(GU) toxicity scoring post RT using the CTCAE v4.0 scoring system. All patients included in the study were planned and treated under the same departmental clinical protocol with VMAT and daily online IGRT corrections. Results: 90 patients were treated with 60 Gy in 20 fractions with a median follow up of 48 months. At 4 years bPFS in the empty bladder group was 100 and 98% in the full bladder group (p = 0.27). There were no statistically significant differences in cumulative ≥Grade 2GU (p = 0.10) and GI (p = 0.27) toxicity rates between the two bladder filling protocols. No statistically significant differences in the IGRT setup between the two groups of patients. Although the median treatment times per fraction were not statistically different between the two groups (p = 0.47), patients in the full bladder filling group were required to spend a longer time in the RT department per treatment session for bladder filling. Conclusion: An empty bladder filling protocol has non-inferior bPFS, GI and GU toxicities at 4 years in patients with localised prostate cancer using advanced RT techniques in comparison to a full bladder filling protocol. A longer follow up with a larger sample size is required to validate this approach. Advances in knowledge: This study suggests that an empty bladder filling protocol can be used in external beam EBRT for localised prostate cancer with non-inferior treatment outcomes.

ASSESSING THE DAILY CONSISTENCY OF BLADDER FILLING PRIOR TO CONFORMAL PROSTATE RADIOTHERAPY USING AN ULTRASONIC BLADDERSCAN DEVICE

2009 ◽  
Vol 92 ◽  
pp. S130
Author(s):  
S. Hynds ◽  
C. McGarry ◽  
D. Mitchell ◽  
S. Early ◽  
L. Shum ◽  
...  
Keyword(s):  
Prostate Radiotherapy ◽  
Bladder Filling

Variations of Urinary Bladder and the Urogenital Fatty Fascial Compartment with Different Filling of the Bladder are Notable Factors Relevant to Hernia Repair-Related Bladder Injury

2013 ◽  
Vol 79 (2) ◽  
pp. 167-174 ◽  
Author(s):  
Zhi-Peng Jiang ◽  
Dong-Ye Wang ◽  
Dong-Ming Lai ◽  
Quan-Bo Zhou ◽  
Yu-Chao Zhang ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ct Scan ◽  
Three Dimensional ◽  
Ct Scanning ◽  
Lateral View ◽  
Three Dimensions ◽  
Bladder Injury ◽  
Mesh Migration ◽  
Bladder Filling ◽  
Empty Bladder

The present study investigated bladder and urogenital fatty fascial compartment (UFFC) variations during bladder filling in an attempt to identify other possible causes of hernia repair-related bladder injury besides mesh migration. The study included 30 patients scheduled for abdominal computed tomography (CT) scan for nonhernia diseases. Sixty-four-slice CT scan was performed immediately after urination and no more than 30 minutes later. Three-dimensional images were constructed by two independent experienced readers. The empty bladder was triangular in shape, narrow in the front and broad in the rear. Its vertex deviated from midline of the abdominal wall in 11 cases (36.7%). With normal filling, it appeared as an irregular oval shape. Only two cases (6.7%) of empty bladder extended inside Hesselbach's triangle. However, this area was occupied to some extent in all cases during bladder filling ( P = 0.003). The UFFC formed a molar-like structure in cross-section. In three dimensions, it appeared as an inverted V-shaped structure from the front. In the lateral view it appeared as a spoon that contained the bladder. UFFC volume increased from 61.85 ± 6.23 to 139.23 ± 5.29 cm3 with bladder filling ( P < 0.0001). The UFFC can be clearly identified by CT scanning or three-dimensional reconstruction. The considerable spatial variation of the UFFC and movement and deformation of the mesh within this area may be related to bladder injury.

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