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15.11.2018 | Original Article

Impact of bladder volume on acute genitourinary toxicity in intensity modulated radiotherapy for localized and locally advanced prostate cancer

verfasst von: Arne Grün, MD, Michael Kawgan-Kagan, MD, David Kaul, PhD, Harun Badakhshi, PhD, Carmen Stromberger, MD, Professor Volker Budach, Dirk Böhmer, PhD

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 6/2019

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Abstract

Background and purpose

To evaluate the effect of changes in bladder volume during high-dose intensity-modulated-radiotherapy (IMRT) of prostate cancer on acute genitourinary (GU) toxicity and prospectively evaluate a simple biofeedback technique for reproducible bladder filling with the aim of reducing acute GU toxicity.

Methods

One hundred ninety-three patients were trained via a biofeedback mechanism to maintain a partially filled bladder with a reproducible volume of 200–300 cc at planning CT and subsequently at each fraction of radiotherapy. We prospectively analyzed whether and to what extent the patients’ ability to maintain a certain bladder filling influenced the degree of acute GU toxicity and whether cut-off values could be differentiated.

Results

We demonstrated that the ability to reach a reproducible bladder volume above a threshold volume of 180 cc and maintain that volume via biofeedback throughout treatment predicts for a decrease in acute GU toxicity during curative high-dose IMRT of the prostate. Patients who were not able to reach a partial bladder filling to that cut-off value and were not able to maintain a partially filled bladder throughout treatment had a significantly higher risk of developing ≥grade 2 GU acute toxicity.

Conclusion

Our results support the hypothesis that a biofeedback training for the patient is an easy-to-apply, useful, and cost-effective tool for reducing acute GU toxicity in high-dose IMRT of the prostate. Patients who are not able to reach and maintain a certain bladder volume during planning and treatment—two independent risk factors—might need special consideration.

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Titel: Impact of bladder volume on acute genitourinary toxicity in intensity modulated radiotherapy for localized and locally advanced prostate cancer
verfasst von: Arne Grün, MD
Michael Kawgan-Kagan, MD
David Kaul, PhD
Harun Badakhshi, PhD
Carmen Stromberger, MD
Professor Volker Budach
Dirk Böhmer, PhD
Publikationsdatum: 15.11.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 6/2019
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-018-1398-8

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Impact of bladder volume on acute genitourinary toxicity in intensity modulated radiotherapy for localized and locally advanced prostate cancer

Abstract

Background and purpose

Methods

Results

Conclusion

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ICI-Therapie in der Schwangerschaft wird gut toleriert

Krebspatienten impfen: Was? Wen? Und wann nicht?

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Background and purpose

Methods

Results

Conclusion

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