Department of Radiotherapy and Oncology, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Int J Radiat Oncol Biol Phys. 2013 Apr 1;85(5):e217-22. doi: 10.1016/j.ijrobp.2012.09.037.
To compare bladder and rectum doses with the use of a bladder-rectum spacer balloon (BRSB) versus standard gauze packing in the same patient receiving 2 high-dose-rate intracavitary brachytherapy fractions.
This was a randomized study to compare the reduction in bladder and rectum doses with the use of a BRSB compared with standard gauze packing in patients with carcinoma of the cervix being treated with high-dose-rate intracavitary brachytherapy. The patients were randomized between 2 arms. In arm A, vaginal packing was done with standard gauze packing in the first application, and BRSB was used in the second application. Arm B was the reverse of arm A. The International Commission for Radiation Units and Measurement (ICRU) point doses and doses to 0.1-cm(3), 1-cm(3), 2-cm(3), 5-cm(3), and 10-cm(3) volumes of bladder and rectum were compared. The patients were also subjectively assessed for the ease of application and the time taken for application. Statistical analysis was done using the paired t test.
A total of 43 patients were enrolled; however, 3 patients had to be excluded because the BRSB could not be inserted owing to unfavorable local anatomy. Thus 40 patients (80 plans) were evaluated. The application was difficult in 3 patients with BRSB, and in 2 patients with BRSB the application time was prolonged. There was no significant difference in bladder doses to 0.1 cm(3), 1 cm(3), 2 cm(3), 5 cm(3), and 10 cm(3) and ICRU bladder point. Statistically significant dose reductions to 0.1-cm(3), 1-cm(3), and 2-cm(3) volumes for rectum were observed with the BRSB. No significant differences in 5-cm(3) and 10-cm(3) volumes and ICRU rectum point were observed.
A statistically significant dose reduction was observed for small high-dose volumes in rectum with the BRSB. The doses to bladder were comparable for BRSB and gauze packing. Transparent balloons of variable sizes are recommended for patients with a less spacious vaginal cavity.
比较使用膀胱-直肠间隔球囊（BRSB）与标准纱布填塞在接受 2 次高剂量率腔内近距离治疗的同一患者中对膀胱和直肠剂量的影响。
这是一项随机研究，比较了使用 BRSB 与标准纱布填塞在接受高剂量率腔内近距离治疗的宫颈癌患者中减少膀胱和直肠剂量的效果。患者随机分为 2 组。在 A 组中，第一次应用时使用标准纱布填塞阴道，第二次应用时使用 BRSB。B 组与 A 组相反。比较了国际辐射单位和测量委员会（ICRU）点剂量以及膀胱和直肠 0.1cm³、1cm³、2cm³、5cm³和 10cm³体积的剂量。还对患者的应用方便程度和应用时间进行了主观评估。使用配对 t 检验进行统计学分析。
共纳入 43 例患者，但因局部解剖结构不利无法插入 BRSB 而排除 3 例。因此，共评估了 40 例患者（80 例计划）。BRSB 应用困难的患者有 3 例，应用时间延长的患者有 2 例。膀胱 0.1cm³、1cm³、2cm³、5cm³和 10cm³剂量和 ICRU 膀胱点无显著差异。BRSB 可显著降低直肠 0.1cm³、1cm³和 2cm³体积的剂量。5cm³和 10cm³体积以及 ICRU 直肠点无显著差异。
BRSB 可显著降低直肠小高剂量体积的剂量。BRSB 与纱布填塞的膀胱剂量相当。对于阴道腔较小的患者，建议使用不同大小的透明球囊。
