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[Normal tissue tolerance to external beam radiation therapy: bladder].

Y Pointreau¹, I Atean, C Durdux

¹Service de Radiothérapie Corad, Centre Régional Universitaire de Cancérologie Henry-S-Kaplan, hôpital Bretonneau-2, CHU de Tours, boulevard Tonnellé, 37000 Tours, France.

Cancer Radiotherapie : Journal De La Societe Francaise De Radiotherapie Oncologique

|May 4, 2010

Summary

Radiation therapy for pelvic cancers can cause bladder side effects like urinary frequency and hematuria. Understanding radiation cystitis risks and dose constraints is crucial for managing bladder toxicity.

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Area of Science:

Oncology
Radiation Oncology
Urology

Background:

The bladder, a key organ for urinary continence, is frequently exposed to ionizing radiation during pelvic radiotherapy.
Radiation exposure can lead to acute and late urinary side effects, including frequency, compliance issues, and hematuria.
The incidence and specific modalities of radiotherapy causing these urinary side effects are not well-documented.

Purpose of the Study:

To review and describe urinary side effects resulting from radiation therapy to the bladder.
To explore the incidence and factors contributing to radiation-induced bladder toxicity.
To discuss current recommendations and clinical considerations for bladder dose constraints in radiotherapy.

Main Methods:

A literature search was conducted using PubMed with keywords such as 'bladder', 'radiotherapy', 'toxicity', 'radiation cystitis', 'tolerability', and 'organ at risk'.

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The review focused on studies describing urinary side effects and established dose constraints for the bladder.

Analysis considered different clinical scenarios, including bladder cancer treatment and pelvic tumors where the bladder is an organ at risk.

Main Results:

Radiation cystitis risk escalates with higher total doses (over 60 Gy), larger irradiated bladder volumes, and concurrent chemoradiation.
Existing dose constraints for the bladder are primarily derived from prostate radiotherapy studies, lacking definitive consensus.
Clinical practice involves adjusting dose constraints based on the specific cancer type and treatment intent.

Conclusions:

Radiation therapy for pelvic malignancies poses a risk of bladder toxicity, manifesting as radiation cystitis.
Careful consideration of dose, volume, and treatment techniques is essential for minimizing bladder damage.
Advanced radiotherapy techniques like intensity-modulated radiation therapy (IMRT) hold promise for reducing bladder toxicity.