How do you manage bladder fullness during cervical T&O brachytherapy to minimize OAR dose?
Small bowel is usually the dose limiting OAR while planning cervical HDR brachytherapy. Having the bladder empty during treatment planning and delivery is to ensure consistent anatomy. By filling the bladder with a consistent amount of saline (~150cc) for the planning and delivery portion of the procedure, one could potentially reduce the dose to the small bowel and get improved coverage of the HR-CTV.
2 Answers
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Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
We usually treat with empty bladder as it is reproducible. But if at first fraction any loop of small bowel close by then for remaining fractions we simulate and treat with full bladder to decrease dose to small bowel (usually 120-180 cc fluid).
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Mednet Member
Radiation Oncology · Vanderbilt-Ingram Cancer Center
Answered on · Updated on
We usually end up instilling fluid into the bladder (100-200cc) and clamp Foley at time of CT simulation. At times, patients develop some pressure sensation during the wait between CT sim and treatment, at which point we instruct nursing to unclamp temporarily, as patients are continuing to generate...
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