Abstract
Background and Purpose:
To evaluate variation in bladder volume of full bladders in definitive radiotherapy for localized prostate cancer and to investigate potential predictors of increased bladder volume variations.
Patients and Methods:
In 40 patients, the bladder volume was measured with megavoltage computed tomography (MVCT) imaging performed just before irradiation during the administration of the 1st fraction (#1), the 10th fraction (#10), the 20th fraction (#20), and the 30th fraction (#30). Patients were instructed to avoid urinating for 60–90 minutes before the planning CT (pln-CT) scan and before daily irradiation. Patients were also encouraged to drink an unspecified volume of liquid that would result in a clear but tolerable urge to urinate.
Results:
The population-mean bladder volume (±1SD) was 219 ml (±83 ml) at the planning CT scan (pln-CT), 186 ml (±96 ml) at #1, 149 ml (±73 ml) at #10, 137 ml (±59 ml) at #20, and 136 ml (±60 ml) at #30. The mean intrapatient variation in bladder volume (1 SD relative to the mean bladder volume of each patient) was 38% (range: 10–84%). The bladder volume at the pln-CT was correlated with the intrapatient variance in bladder volume with a correlation coefficient of 0.54 and p <0.001.
Conclusion:
We observed a significant decline in bladder volumes during the course of radiotherapy. The bladder volume at the pln-CT was a significant predictor of increased bladder volume variations.
Zusammenfassung
Hintergrund und Zweck:
Die Evaluierung der Schwankungen des Blasenvolumens gefüllter Blasen in der definitiven Radiotherapie bei lokalisiertem Prostatakrebs sowie die Untersuchung potenzieller Prädiktoren für erhöhte Schwankungen des Blasenvolumens.
Patienten und Methoden:
Das Blasenvolumen von vierzig Patienten wurde mittels Megavoltage-Computertomographie (MVCT) bestimmt, die bei der Verabreichung der 1. Fraktion (#1), der 10. Fraktion (#10), der 20. Fraktion (#20) und der 30. Fraktion (#30) kurz vor der Bestrahlung durchgeführt wurde. Die Patienten wurden angewiesen, 60–90 Minuten vor dem Planungs-CT (pln-CT)- Scan und vor der täglichen Bestrahlung nicht zu urinieren. Die Patienten wurden zudem ermuntert, eine nicht näher bestimmte Menge an Flüssigkeit zu sich zu nehmen, um einen deutlichen aber tolerierbaren Harndrang herbeizuführen.
Ergebnisse:
Der Mittelwert der Grundgesamtheit des Blasenvolumens (±1SA) lag beim Planungs-CT-Scan (pln-CT) bei 219 ml (±83 ml), 186 ml (±96 ml) bei #1, 149 ml (±73 ml) bei #10, 137 ml (±59 ml) bei #20 und 136 ml (±60 ml) bei #30. Der Mittelwert der Schwankung des Blasenvolumens innerhalb eines Patienten (1SA bezogen auf den Mittelwert des Blasenvolumens des einzelnen Patienten) lag bei 38 % (Spannweite: 10–84 %). Das Blasenvolumen zum Zeitpunkt des pln-CT wurde mit der Streuung des Blasenvolumens innerhalb eines Patienten korreliert, woraus sich ein Korrelationskoeffizient von 0,54 mit p <0,001 ergab.
Fazit:
Im Laufe der Radiotherapie konnte eine deutliche Verringerung der Blasenvolumen festgestellt werden. Das Blasenvolumen zum Zeitpunkt des pln-CT-Scans erwies sich als signifikanter Prädiktor erhöhter Schwankungen im Blasenvolumen.
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Nakamura, N., Shikama, N., Takahashi, O. et al. Variability in Bladder Volumes of Full Bladders in Definitive Radiotherapy for Cases of Localized Prostate Cancer. Strahlenther Onkol 186, 637–642 (2010). https://doi.org/10.1007/s00066-010-2105-6
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DOI: https://doi.org/10.1007/s00066-010-2105-6