A Comparative study of bladder volume to optimize radiation therapy in prostate cancer patients.
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Abstract
Maintaining a full bladder volume on the radiation therapy day as close as possible to the simulation day is crucial for the accuracy and efficacy of prostate cancer treatment. This research aimed to compare bladder volume between the simulation day and the radiation therapy day in 33 patients at the National Cancer Institute, selected according to specified criteria. Bladder volume on the simulation day was calculated from CT simulator images and compared to bladder volume on the radiation therapy day from cone-beam computed tomography (CBCT) images.
The study results showed that the median bladder volume on the simulation day and the radiation day was 113.92 (91.08-134.38) and 112.08 (91.59-140.71) ml, respectively, which were not statistically significant (p = 0.057). However, bladder size along the X-axis (left-right) and Z-axis (head-foot) differed significantly (p<0.001 and p=0.032, respectively), but not significantly along the Y-axis (front-back) (p=0.465). Furthermore, urinary continence duration and the number of imaging sessions between the simulation day and the radiation day differed significantly (p<0.001). Generalized Estimating Equation (GEE) analysis revealed a statistically significant correlation between bladder volume (β =0.53, 95% CI: 0.24-0.84, p<0.001), with position. The bladder correlation was statistically significant across all three axes (p < 0.05), with the Z-axis (head-foot) showing the strongest correlation.
In summary, a comparative study of bladder volume between the treatment simulation day and the radiation therapy day found that full bladder preparation helps prostate cancer patients maintain their bladder volume levels. The bladder volume on the day of radiation therapy was not statistically significant (p = 0.057), with median values of 113.92 ml and 112.08 ml, respectively. The GEE model confirmed a statistically significant positive correlation between bladder volumes on both days (β = 0.53, p < 0.001). However, significant differences in bladder size were found in the X-axis (left-right) and Z-axis (head-foot) (p < 0.001 and p = 0.032, respectively), reflecting changes in bladder shape in these two directions. The Y-axis (anterior-posterior) did not show a statistically significant difference (p = 0.465). Furthermore, a statistically significant correlation (p < 0.001) was found between urinary continence duration and the number of pre irradiation CBCT scans. This reflects the inconsistency in daily urinary continence duration among patients, directly impacting bladder changes. Increasing the number of CBCT scans to adjust the bladder position before radiation therapy is crucial for treatment planning.
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บทความทีตีพิมพ์ในวารสารโรคมะเร็งนี้ถือว่าเป็นลิขสิทธิ์ของมูลนิธิสถาบันมะเร็งแห่งชาติ และผลงานวิชาการหรือวิจัยของคณะผู้เขียน ไม่ใช่ความคิดเห็นของบรรณาธิการหรือผู้จัดทํา
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