Bladder extension variability during pelvic external beam radiotherapy with a full or empty bladder

Pinkawa, Michael; Asadpour, Branka; Siluschek, Jaroslav; Gagel, Bernd; Piroth, Marc D.; Demirel, Cengiz Bekir; Eble, Michael J.

doi:10.1016/j.radonc.2007.03.015

Cited by 45 publications

(39 citation statements)

References 18 publications

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“…This finding is in accordance to the study of O'Doherty et al [21] and other authors [1,31,40] that ascribe the volume reduction to a side effect of treatment. We observed the same trend in volume reduction for the empty bladder and these data agree with those reported by O'Doherty et al [21] and Pinkawa et al [24,25]. Concerning the rectum, Figure 3 shows that the volume is constant within the same CT series, which shows the goodness of the patient selection.…”

Section: Discussionsupporting

confidence: 91%

“…In clinical experience, it is widely accepted that treatment with an empty bladder allows a more reproducible anatomy to be achieved [18,38]. Dawson et al [7] reported that even in this case the bladder volume is not constant during the treatment; the same observation was reported by Pinkawa et al [25]. O'Doherty et al [21] reported that patients informed to drink the same amount of liquid before every treatment are more able to maintain a constant bladder volume, although Nakamura et al [20] observed a significant decline in bladder volumes during the course of radiotherapy.…”

Section: Introductionmentioning

confidence: 79%

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Physical and clinical implications of radiotherapy treatment of prostate cancer using a full bladder protocol

et al. 2011

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 79%

Physical and clinical implications of radiotherapy treatment of prostate cancer using a full bladder protocol

et al. 2011

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“…Second, due to generally open bladder filling protocol in the trial where centres may decide to use empty or full bladder, there were large variations of bladder volume. The relative surface of bladder receiving a particular dose threshold may be impacted by the bladder filling due to the expansion of the bladder, known to be anisotropic, and this may influence the resultant dosimetric impact [39].…”

Section: Discussionmentioning

confidence: 99%

Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

Yahya

Ebert

Bulsara

et al. 2015

Radiotherapy and Oncology

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Urinary symptoms (frequency, incontinence, dysuria and haematuria) were prospectively assessed using LENT-SOMA to a median of 72 months. The endpoints assessed were prevalence (grade≥1) at the end of radiotherapy (representing acute symptoms), at 18-, 36-and 54-month follow-ups (representing late symptoms) and peak late incidence including only grade≥2. Impact of factors were assessed using multivariate logistic regression models with correction for over-optimism. Results: Baseline symptoms, non-insulin dependent diabetes mellitus, age and PC1 (correlated to the mean dose) impact symptoms at >1 timepoints. Associations at a single timepoint were found for cerebrovascular condition, ECOG status and non-steroidal anti-inflammatory drug intake. Peak incidence analysis shows the impact of baseline, bowel and cerebrovascular condition and smoking status. Conclusions:The prevalence and incidence analysis provide a complementary view for urinary symptom prediction. Sustained impacts across time points were found for several factors while some associations were not repeated at different time points suggesting poorer or transient impact.4

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“…We asked the patients to have a comfortably full bladder, i.e. the feeling of having a full bladder during treatment [23].…”

Section: Treatment Planningmentioning

confidence: 99%

The effect of concurrent androgen deprivation and 3D conformal radiotherapy on prostate volume and clinical organ doses during treatment for prostate cancer

Onal

Topkan²,

Efe³

et al. 2009

BJR

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ABSTRACT. In this study, we investigated the shrinking effect of concurrent threedimensional conformal radiotherapy (3D-CRT) and androgen deprivation (AD) on prostate volume, and its possible impact on the dose received by the rectum and bladder during the course of 3D-CRT. The difference between the prostatic volumes determined on pre-treatment planning CT (PL-CT) and post-treatment CT (PT-CT) following a 3D-CRT course was assessed in 52 patients with localised prostate carcinoma. The changes in mean prostate volume when compared with PL-CT and PT-CT-based measurements were assessed. The pre-and post-treatment mean prostate volumes for the whole study population were 49.7 cm 3 and 41.0 cm 3 (p50.02), respectively. The study cohort was divided into two groups depending on the duration of neoadjuvant androgen deprivation (NAD): 23 patients (44.7%) were designated as ''short NAD'' (#3 months; SNAD) and the remaining 29 (55.3%) as ''long NAD'' (.3 months; LNAD). Patients on SNAD experienced a significantly greater reduction in prostate volume compared with those on LNAD (14.1% vs 5.1%; p50.03). A significant increase in rectum V 40-60 values in PT-CT compared with PL-CT was demonstrated. LNAD patients had significantly higher rectal V 50-70 values at PT-CT compared with the SNAD group. There was a significant decline in V 30 -V 75 bladder values in PT-CT compared with PL-CT in the SNAD group. In conclusion, a higher prostate volume reduction during 3D-CRT was demonstrated when RT planning was performed within 3 months of NAD. However, this reduction and daily organ motion may lead to an unpredictable increase in rectal doses. Neoadjuvant androgen deprivation (NAD) before RT has been demonstrated to shrink the prostate volume effectively [11,12], and thus has became a widely accepted and essential part of locally advanced prostate cancer management. On average, the prostate gland shrinks about 20-50% of its initial volume within 3 months of NAD [11][12][13][14][15] and, although the rate slows down, this shrinking effect continues beyond this period [16][17][18][19] The cytoreduction in the prostate provided by NAD may lower the complication rates observed at higher RT doses by reducing the target volumes, depending on the reduced doses received by normal tissues [15,20].A relatively long treatment interval (7-8 weeks) is usually mandated for three-dimensional conformal radiotherapy (3D-CRT) of prostate carcinoma, and the shrinkage of the prostate gland continues during this period. In this setting, it is reasonable to assume, theoretically, that there is a possibility of a larger than planned volume of surrounding critical organs that may shift into the intermediate or high-dose regions during the RT course, which may unpredictably increase the dose received by the rectum and bladder [11,12,21]. Based on the above assumption, we planned to evaluate prostate shrinkage during 3D-CRT in relation to NAD duration, and to investigate the possible impact of this volume reduction on the dose received by the rectum and blad...

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Bladder extension variability during pelvic external beam radiotherapy with a full or empty bladder

Cited by 45 publications

References 18 publications

Physical and clinical implications of radiotherapy treatment of prostate cancer using a full bladder protocol

Physical and clinical implications of radiotherapy treatment of prostate cancer using a full bladder protocol

Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

The effect of concurrent androgen deprivation and 3D conformal radiotherapy on prostate volume and clinical organ doses during treatment for prostate cancer

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