IMPACT OF BLADDER DISTENSION ON ORGANS AT RISK IN 3D INTRACAVITARY BRACHYTHERAPY FOR CERVICAL CANCER

Authors

  • Hooryia Bajwa Princess Nora Bint Abdulrehman University, Riyadh, Saudi Arabia
  • Muhammad Ali Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
  • Bilal Muhammad Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
  • K Rehman Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
  • Imran Niazi Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
  • Irfan Haider Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan

DOI:

https://doi.org/10.53555/eijmhs.v4i2.25

Keywords:

organ at risk (OAR), HDR, D2CC, D50%

Abstract

Objectives:

To determine the effects of bladder distension on organs at risk (OAR) during ICBT for cervical cancer with 3D Imaging based Planning.

 Materials and methods:

Twenty-eight patients with cervical cancer who received high-dose radiation (HDR) brachytherapy using 7Gy x 4 fractions, were included in the study. For three-dimensional (3D) analysis, pelvic CT scans were obtained with indwelling catheters in place (defined as empty bladder) and repeated scans with 200-cc of sterile water in their bladders (defined as full bladder). To compare the International Commission on Radiation Units and Measurements (ICRU) point doses with 3D-volume doses, the volume dose was defined by using two different criteria, D2cc (the minimum dose value in a 2.0-cm3 volume receiving the highest dose) and D50% (the dose received by 50% of the volume of the OAR) for OARs. 

Results:

For patients with a full bladder, the mean bladder D2cc increased from 395 to 558.4 cGy (41%, p < 0.001). However, the bowel D2cc and sigmoid colon D2cc decreased from 477.4 to 216.1 cGy (55.0%, p < 0.001) and 450.8 to 350.8 cGy (22%, p= 0.001), respectively. The mean D50% values of both the bladder and the bowel decreased from 301.6 to 227.3 cGy (25%, p < 0.001) and from 116.5 to 74.3 cGy (36%, p < 0.001) with a full bladder, respectively. The mean D50% for sigmoid colon also decreased from 148 cGy to 119.3 cGy (19%, p< 0.001) with bladder distension. However, there was no significant difference in rectal D2cc and D50% values. 

Conclusion:

Full bladder technique reduces sigmoid colon and bowel wall radiation exposure. The bladder gets a higher point dose and rectum remains unaffected.

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Published

2017-03-27

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Vol. 3 No. 1 (2017): EPH - International Journal of Medical and Health Science (ISSN: 2456 - 6063)

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