When treating with chemo/RT for bladder cancer, how concerned are you with small bowel dose constraints when boosting the bladder to 60 Gy?
Realistically, there will always be some (hopefully small) inconsistency with bladder filling, and thus some small bowel could easily receive ≥60 Gy, especially when boosting the dome of the bladder. Do you rely on the fact that with no prior abdominal surgery, it will not always be the same segment of small bowel receiving that dose?
Answer from: Radiation Oncologist at Academic Institution
This is an excellent question, and something we struggle with. DVH parameters are important considerations, but I also feel that sometimes we put too much emphasis on dose contraints; as if the sky will fall if you pass a threshold. Exceeding a parameter is no guarantee of good or bad outcome, but...
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