| Ma Jianping,Xia Xinshe,Pan Wenyan,et al.The impact of bladder filling status on the movement of uterus and the volume of organs at risk in intensity modulated radiotherapy of cervical cancer[J].Chinese Journal of Radiological Medicine and Protection,2019,39(9):652-657 |
| The impact of bladder filling status on the movement of uterus and the volume of organs at risk in intensity modulated radiotherapy of cervical cancer |
| Received:March 01, 2019 |
| DOI：10.3760/cma.j.issn.0254-5098.2019.09.003 |
| KeyWords:Cervical cancer Intensity modulated radiotherapy Bladder filling Displacement Organs at risk |
| FundProject:宁夏回族自治区重点研发计划项目（2016KJHM67） |
| Author Name | Affiliation | E-mail | | Ma Jianping | General Hospital of Ninxia Medical University, Yinchuan 750004, China | | | Xia Xinshe | General Hospital of Ninxia Medical University, Yinchuan 750004, China | | | Pan Wenyan | General Hospital of Ninxia Medical University, Yinchuan 750004, China | | | He Jianli | General Hospital of Ninxia Medical University, Yinchuan 750004, China | | | Ye Hongqiang | General Hospital of Ninxia Medical University, Yinchuan 750004, China | | | Chen Junjie | General Hospital of Ninxia Medical University, Yinchuan 750004, China | | | Wang Jialin | General Hospital of Ninxia Medical University, Yinchuan 750004, China | | | Wang Yong | General Hospital of Ninxia Medical University, Yinchuan 750004, China | | | Bai Xuehong | General Hospital of Ninxia Medical University, Yinchuan 750004, China | | | Zhe Hong | General Hospital of Ninxia Medical University, Yinchuan 750004, China | 123zhehong@vip.sina.com |
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| Abstract:: |
| Objective To investigate the impact of bladder filling status on the movement of uterine and on the volume of organs at risk(OAR), so as to provide theoretical basis for individualized internal target volume (ITV) and planning target volume (PTV). Methods Simulation CT images for a total of 27 patients with locally advanced cervical cancer were acquired with empty bladder, 1.0 h after bladder filling, 1.5 h after bladder filling, respectively. The volumes of uterine corpus, cervix, OARs, CTV and PTV 1.0 h after bladder filling were delineated. The impact of bladder filling status on the displacements of cervix and corpus, volumetric changes of rectum, small intestine, and the volumes of small intestine, bladder and rectum within PTV were analyzed. The correlation between bladder filling status and uterine displacement and volume of OAR was also investigated, as well as the volume of cervix and corpus in the PTV with empty bladder and 1.5 h after bladder filling. Results Bladder filling status is different for individual cases. The maximum movement range of cervix and uterine body with bladder filling state was 0-3.04 cm and 0-4.31 cm respectively. The anterior displacements of corpus (F=7.818, P<0.05), the volumetric changes of blander, as well the volume of bladder and small intestine in the PTV (F=46.197, 44.609, 29.546, P<0.05) were significantly different between different bladder filling status. The bladder filling status was correlated with the displacements of the anterior of corpus, volumetric changes of small intestine, and the volumes of bladder and small intestine within the PTV (r=-0.232, -0.298, 0.915, -0.336, P<0.05). The volumes of cervix and corpus out of the PTV were significantly different between the empty bladder and 1.5 h after bladder filling (t=-1.326, -1.559, P<0.05). Conclusions Bladder filling status was different for individual patients. The displacements of the anterior of the corpus were significantly affected by the bladder filling status. Increasing the anterior margin of PTV was recommended. The consistency of bladder filling status was critical for the precise cervical cancer IMRT. |
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