eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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vol. 15
Original paper

Variations and effects of bladder and rectal volume following uniform preparation procedure in cervical cancer: Five fractions of 6 Gy

Bin-Qiang Ye
Cheng-Zong Zhao
Peng-Fei Sun

Department of Radiotherapy, Second Hospital Affiliated to Lanzhou University, Lanzhou, 730030, China
J Contemp Brachytherapy 2023; 15, 2: 123–129
Online publish date: 2023/04/28
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To analyze the effects of different bladder and rectal volumes on the dose of organ at risks (OARs) and primary tumors following uniform preparation procedure.

Material and methods:
In this retrospective study, a total of 60 patients with cervical cancer treated with external beam radiation therapy (EBRT) combined with chemotherapy and brachytherapy (BT) during 2019-2022 were included (300 insertions). Then, tandem-ovoid applicators were placed and computed tomography (CT) scanning was performed after each insertion. Delineation of OARs and clinical target volumes (CTVs) were done according to GEC-ESTRO group recommendations. Finally, doses of high-risk clinical target volume (HR-CTV) and OARs were obtained from dose volume histogram (DVH) automatically generated by BT treatment planning system.

Following a uniform preparation procedure, the median bladder volume of 68.36 cc (range, 29.9-235.68 cc) was in optimal agreement with the recommended bladder volume of ≤ 70 ml, which avoided more manipulation and possible risk of adverse events during general anesthesia. As the bladder filling volume increased, there was no corresponding increase in rectal, HR-CTV, and small bowel volumes, while the sigmoid colon volume decreased. The median rectal volume was 54.95 cc (range, 24.92-168.1 cc), and as the rectal volume increased, HR-CTV, sigmoid colon, and rectum volumes increased, and conversely, small bowel volume decreased. HR-CTV changes with volume affected the rectum, bladder, and HR-CTV, but not the sigmoid colon and small intestine.

Following a uniform preparation procedure, the bladder and rectum can also be controlled to an optimal volume (B ≤ 70 cc, R ≈ 40 cc), which is related to the dose of the bladder, rectum, and sigmoid colon.


bladder volume, rectal volume, brachytherapy, cervical cancer, OARs

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