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01-06-2019 | Original Article

Impact of bladder volume on acute genitourinary toxicity in intensity modulated radiotherapy for localized and locally advanced prostate cancer

Authors: Arne Grün, MD, Michael Kawgan-Kagan, MD, David Kaul, PhD, Harun Badakhshi, PhD, Carmen Stromberger, MD, Professor Volker Budach, Dirk Böhmer, PhD

Published in: Strahlentherapie und Onkologie | Issue 6/2019

Abstract

Background and purpose

To evaluate the effect of changes in bladder volume during high-dose intensity-modulated-radiotherapy (IMRT) of prostate cancer on acute genitourinary (GU) toxicity and prospectively evaluate a simple biofeedback technique for reproducible bladder filling with the aim of reducing acute GU toxicity.

Methods

One hundred ninety-three patients were trained via a biofeedback mechanism to maintain a partially filled bladder with a reproducible volume of 200–300 cc at planning CT and subsequently at each fraction of radiotherapy. We prospectively analyzed whether and to what extent the patients’ ability to maintain a certain bladder filling influenced the degree of acute GU toxicity and whether cut-off values could be differentiated.

Results

We demonstrated that the ability to reach a reproducible bladder volume above a threshold volume of 180 cc and maintain that volume via biofeedback throughout treatment predicts for a decrease in acute GU toxicity during curative high-dose IMRT of the prostate. Patients who were not able to reach a partial bladder filling to that cut-off value and were not able to maintain a partially filled bladder throughout treatment had a significantly higher risk of developing ≥grade 2 GU acute toxicity.

Conclusion

Our results support the hypothesis that a biofeedback training for the patient is an easy-to-apply, useful, and cost-effective tool for reducing acute GU toxicity in high-dose IMRT of the prostate. Patients who are not able to reach and maintain a certain bladder volume during planning and treatment—two independent risk factors—might need special consideration.

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Title: Impact of bladder volume on acute genitourinary toxicity in intensity modulated radiotherapy for localized and locally advanced prostate cancer
Authors: Arne Grün, MD
Michael Kawgan-Kagan, MD
David Kaul, PhD
Harun Badakhshi, PhD
Carmen Stromberger, MD
Professor Volker Budach
Dirk Böhmer, PhD
Publication date: 01-06-2019
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 6/2019
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-018-1398-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Impact of bladder volume on acute genitourinary toxicity in intensity modulated radiotherapy for localized and locally advanced prostate cancer

Abstract

Background and purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background and purpose

Methods

Results

Conclusion

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