Wang H, Jiang S K, Peng R, Huang Y, Wang M Q, Wang J J, Liu C, Zhang F, Ma L L
Department of Radiation Oncology.
Department of Urology, Peking University Third Hospital, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Aug 18;52(4):688-691. doi: 10.19723/j.issn.1671-167X.2020.04.017.
To explore the training mode of individual urine volume control, to take indi-vidual expected urine volume as the goal of bladder control in patients with urinary system tumors, and to improve the accuracy of bladder control during radiotherapy by active training of bladder receptivity.
Twenty-five patients of urinary system tumors were enrolled from May 2019 to September 2019, of whom, 21 patients had prostate cancer, and 4 had bladder cancer. Training of bladder filling started before CT simulation. The patients were required to take the individual bladder filling as the training goal, and the optimal bladder volume range was suggested to be 200－400 mL. After 2－4 weeks of training, the prescribed volume of the bladder was determined according to the patient's bladder receptivity. The volume of the bladder was measured by images of plain CT and images 8-minutes after intravenous contrast injection. The patient's bladder volume was measured using BladderScan before treatment. CBCT (Cone-beam CT) was performed, and bladder volume was measured before treatment. The bladder volume was measured again using BladderScan after treatment.
The mean bladder volume of simulation (V) was (262±130) mL, ranging from 78 mL to 505 mL. The mean self-evaluation bladder volume before radiotherapy (V) was (238±107) mL, ranging from 100 mL to 400 mL. The mean BladderScan measured volume before radiotherapy (V) was (253±123) mL, ranging from 60 mL to 476 mL. The mean cone-beam CT measured volume before radiotherapy (V) was (270±120) mL, ranging from 104 mL to 513 mL. There was a correlation between V and V, V and V, V and V, and there was no significant difference in paired -test. There was a correlation between differences of self-evaluation bladder volume before radiotherapy(V) and simulation CT (V) and differences of self-evaluation bladder volume before radiotherapy (V) and cone-beam CT (V), and there was no significant difference in paired samples by -test.
During radiotherapy for urinary system tumors, such as prostate cancer and bladder cancer, with the assistance of BladderScan, the patients could try to hold their urine moderately according to their conditions, and individualized bladder prescription may be beneficial to achieve stable bladder volume during radiotherapy.
探索个体化尿量控制训练模式，将个体化预期尿量作为泌尿系统肿瘤患者膀胱控制目标，通过主动训练膀胱耐受性提高放疗期间膀胱控制的准确性。
选取2019年5月至2019年9月收治的25例泌尿系统肿瘤患者，其中前列腺癌21例，膀胱癌4例。在CT模拟前开始膀胱充盈训练。要求患者以个体化膀胱充盈为训练目标，建议最佳膀胱容量范围为200～400 mL。经过2～4周训练后，根据患者膀胱耐受性确定膀胱处方量。通过平扫CT图像及静脉注射造影剂8分钟后的图像测量膀胱容量。治疗前使用膀胱扫描仪测量患者膀胱容量。进行锥形束CT（CBCT）扫描，并在治疗前测量膀胱容量。治疗后再次使用膀胱扫描仪测量膀胱容量。
模拟时平均膀胱容量（V）为（262±130）mL，范围为78～505 mL。放疗前自我评估膀胱容量平均（V）为（238±107）mL，范围为100～400 mL。放疗前膀胱扫描仪测量平均容量（V）为（253±123）mL，范围为60～476 mL。放疗前锥形束CT测量平均容量（V）为（270±120）mL，范围为104～513 mL。V与V、V与V、V与V之间存在相关性，配对检验无显著差异。放疗前自我评估膀胱容量（V）与模拟CT（V）的差值和放疗前自我评估膀胱容量（V）与锥形束CT（V）的差值之间存在相关性，配对样本检验无显著差异。
在前列腺癌、膀胱癌等泌尿系统肿瘤放疗期间，借助膀胱扫描仪，患者可根据自身情况适度憋尿，个体化膀胱处方可能有利于放疗期间实现稳定的膀胱容量。
