Sweta Bandanatham1, Janaki Manur Gururajachar2, Mohan Kumar Somashekar2. 1. Department of Radiotherapy, Government Medical College, Kurnool, Andhra Pradesh, India. 2. Department of Radiotherapy, MSR Medical College, Gokula, Bangalore, Karnataka 560054, India.
Abstract
AIM: This prospective study aims to assess the compliance with bladder protocol and the correlation with enteritis during pelvic radiation. BACKGROUND: Bladder protocol is routinely used for patients undergoing pelvic radiation to reduce radiation enteritis. It is very difficult to maintain constant volume especially in the last two weeks due to radiation enteritis and cystitis. MATERIALS AND METHODS: Histologically proven 35 cervical cancer patients treated with concurrent chemoradiation in a tertiary care center were the subjects of this prospective study. Following CT simulation and after every fraction, patients were asked to void urine in a calibrated urine container and the volume was documented. Patients were assessed for the highest grade of radiation enteritis weekly as per common toxicity criteria. The mean voided urine volume was correlated with the radiation enteritis. RESULTS: The mean urine volume at planning CT scan was 295.85 ± 300 ml (SD) with a range of 75-650. At the end of treatment, it was reduced to 233.14 ± 250 ml (range 50-400 ml), a reduction by 21% (p < 0.001). The maximum grade of enteritis was grade I (11%), II (11.4%), III (3-29%) in week 1,2 and 3-5, respectively with a p value of <0.001. A mean urine volume of 230 ml was associated with grade III enteritis in the third week. CONCLUSIONS: Urine output volume measured using a calibrated container is a simple, efficient and practical method to monitor bladder distension thereby reducing enteritis in cervical cancer patients treated with concurrent chemoradiation.
AIM: This prospective study aims to assess the compliance with bladder protocol and the correlation with enteritis during pelvic radiation. BACKGROUND: Bladder protocol is routinely used for patients undergoing pelvic radiation to reduce radiation enteritis. It is very difficult to maintain constant volume especially in the last two weeks due to radiation enteritis and cystitis. MATERIALS AND METHODS: Histologically proven 35 cervical cancer patients treated with concurrent chemoradiation in a tertiary care center were the subjects of this prospective study. Following CT simulation and after every fraction, patients were asked to void urine in a calibrated urine container and the volume was documented. Patients were assessed for the highest grade of radiation enteritis weekly as per common toxicity criteria. The mean voided urine volume was correlated with the radiation enteritis. RESULTS: The mean urine volume at planning CT scan was 295.85 ± 300 ml (SD) with a range of 75-650. At the end of treatment, it was reduced to 233.14 ± 250 ml (range 50-400 ml), a reduction by 21% (p < 0.001). The maximum grade of enteritis was grade I (11%), II (11.4%), III (3-29%) in week 1,2 and 3-5, respectively with a p value of <0.001. A mean urine volume of 230 ml was associated with grade III enteritis in the third week. CONCLUSIONS: Urine output volume measured using a calibrated container is a simple, efficient and practical method to monitor bladder distension thereby reducing enteritis in cervical cancer patients treated with concurrent chemoradiation.
Authors: S Hynds; C K McGarry; D M Mitchell; S Early; L Shum; D P Stewart; J A Harney; C R Cardwell; J M O'Sullivan Journal: Br J Radiol Date: 2010-12-15 Impact factor: 3.039
Authors: Michael Pinkawa; Branka Asadpour; Bernd Gagel; Marc D Piroth; Richard Holy; Michael J Eble Journal: Int J Radiat Oncol Biol Phys Date: 2005-10-21 Impact factor: 7.038
Authors: P G Rose; B N Bundy; E B Watkins; J T Thigpen; G Deppe; M A Maiman; D L Clarke-Pearson; S Insalaco Journal: N Engl J Med Date: 1999-04-15 Impact factor: 91.245
Authors: John M Kirwan; Paul Symonds; John A Green; Jayne Tierney; Mandy Collingwood; Christopher J Williams Journal: Radiother Oncol Date: 2003-09 Impact factor: 6.280
Authors: Laura M Mullaney; Evelyn O'Shea; Mary T Dunne; Marie A Finn; Pierre G Thirion; Lesley Ann Cleary; Maeve McGarry; Louise O'Neill; John G Armstrong Journal: Pract Radiat Oncol Date: 2014-01-08
Authors: Una M O'Doherty; Helen A McNair; Andrew R Norman; Elizabeth Miles; Simon Hooper; Mark Davies; Naomi Lincoln; Jan Balyckyi; Peter Childs; David P Dearnaley; Robert A Huddart Journal: Radiother Oncol Date: 2006-06-16 Impact factor: 6.280