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