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Does a patient-specific bladder-filling protocol affect bladder volume and dose in postprostatectomy radiotherapy?
Deniz Yalman1, Murat Köylü2, Özge Duran3
1Department of Radiation Oncology, Ege University Medical Faculty, Izmir, Turkey. deniz.yalman@ege.edu.tr.
International Urology and Nephrology
|October 11, 2023
Summary
A patient-specific bladder-filling protocol (PSP) using ultrasound improved bladder volume consistency during radiotherapy for prostate cancer patients. This method ensured optimal and reproducible bladder filling throughout treatment.
Area of Science:
- Radiation oncology
- Medical physics
- Urology
Background:
- Accurate bladder volume management is crucial for effective radiotherapy in postprostatectomy patients.
- Standard bladder filling protocols can lead to significant variations in bladder volume during treatment.
- Variability in bladder volume can impact radiation dose delivery to organs at risk.
Purpose of the Study:
- To develop and evaluate a patient-specific bladder-filling protocol (PSP) using an ultrasound-based bladder scanner (BS).
- To compare volumetric and dosimetric parameters of PSP with the standard filling protocol (SP).
- To assess the reproducibility of bladder filling in postprostatectomy patients undergoing salvage radiotherapy.
Main Methods:
- Twenty postprostatectomy patients receiving salvage radiotherapy (72 Gy/36 fx) were enrolled.
- PSP involved individualized bladder filling based on ultrasound measurements to achieve 150-200 cc volume.
- Standard protocol (SP) relied on patient's subjective feeling of bladder fullness; volumetric and dosimetric data were compared between protocols using planning CT and CBCT scans.
Main Results:
- The patient-specific protocol (PSP) demonstrated a significant difference in mean CBCT bladder volume compared to the standard protocol (SP) (p=0.007).
- No significant differences in mean bladder volume or dose were observed between planning CT and CBCT within the PSP group.
- While SP showed a trend towards significance in mean bladder dose variation (p=0.074), PSP maintained consistent bladder volumes and doses.
Conclusions:
- The patient-specific bladder-filling protocol (PSP) effectively achieved and maintained optimal bladder filling throughout the radiotherapy course.
- PSP demonstrated superior reproducibility in bladder volume compared to the standard protocol.
- This ultrasound-guided approach offers a reliable method for bladder volume management in radiation oncology.
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