For post-prostatectomy radiation, what rectum, sigmoid, and bladder constraints do you use?

Topics: Radiation Oncology • Genitourinary Cancers

Given consensus contours for prostate bed, volumes can approach the sigmoid and include a significant amount of bladder, how do you meet these objectives?

Answer from: Radiation Oncologist at Community Practice

In these cases, I follow consensus guidelines for contouring the CTV_ProsBed and also contour out the sigmoid and any small bowel. I use whole organ volumes, not just wall contours, although there are published constraints for the rectal wall and bladder wall. There are a range of appropriate const...

Comments

Radiation Oncologist at Naval Medical Center San Diego
How would you approach cases with low lying sigmoi...

Radiation Oncologist at University of Pittsburgh
I would agree with Dr. @Bridget F. Koontz. I would...

Answer from: Radiation Oncologist at Community Practice

It's a great question, and definitely occurs from time to time, sometimes with sigmoid, and sometimes with a loop of small bowel! I may be overly cautious, but I follow the "first do no harm" principle. First, I make sure the clinical setup is optimized - is sigmoid in the same position on MRI (whic...

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