Briceño Guel, Diana Nohemi and Laverick, Nicola and MacLaren, Linda and MacLeod, Nicholas and Glegg, Martin and Lamb, Gillian and Houston, Peter and Carruthers, Ross and Grocutt, Laura and Valentine, Ronan (2024) Adaptive radiotherapy for muscle invasive bladder cancer: a retrospective audit of two bladder filling protocols. Radiation Oncology, 19 (1): 92. ISSN 1748-717X
AI Summary:
This study compared a bladder emptying (BE) protocol to a bladder filling (BF) protocol for radical radiotherapy of muscle-invasive bladder cancer. The results showed that the BE protocol had smaller treatment volumes, reduced OAR and total body doses, and more consistent dosimetry throughout the treatment course.AI Topics:
Background:
Radical radiotherapy for muscle-invasive bladder cancer (MIBC) is challenging due to large variations in bladder shape, size and volume during treatment, with drinking protocols often employed to mitigate geometric uncertainties. Utilising adaptive radiotherapy together with CBCT imaging to select a treatment plan that best fits the bladder target and reduce normal tissue irradiation is an attractive option to compensate for anatomical changes. The aim of this retrospective study was to compare a bladder empty (BE) protocol to a bladder filling (BF) protocol with regards to variations in target volumes, plan of the day (PoD) selection and plan dosimetry throughout treatment.
Methods:
Forty patients were included in the study; twenty were treated with a BE protocol and twenty with a BF protocol to a total prescribed dose of 55 Gy in 20 fractions. Small, medium and large bladder plans were generated using three different CTV to PTV margins. Bladder (CTV) volumes were delineated on planning CTs and online pre-treatment CBCTs. Differences in CTV volumes throughout treatment, plan selection, PTV volumes and resulting dose metrics were compared for both protocols.
Results:
Mean bladder volume differed significantly on both the planning CTs and online pre-treatment CBCTs between the protocols (p < 0.05). Significant differences in bladder volumes were observed between the planning CT and pre-treatment CBCTs for BF (p < 0.05) but not for BE (p = 0.11). Both protocols saw a significant decrease in bladder volume between first and final treatment fractions (p < 0.05). Medium plans were preferentially selected for BE whilst when using the BF protocol the small plan was chosen most frequently. With no significant change to PTV coverage between the protocols, the volume of body receiving 25.0–45.8 Gy was found to be significantly smaller for BE patients (p < 0.05).
Conclusions:
This work provides evidence in favour of a BE protocol compared to a BF protocol for radical radiotherapy for MIBC. The smaller treatment volumes observed in the BE protocol led to reduced OAR and total body doses and were also observed to be more consistent throughout the treatment course. These results highlight improvements in dosimetry for patients who undergo a BE protocol for MIBC.
Briceño Guel, Diana Nohemi
Author
Briceño Guel, Diana Nohemi and Laverick, Nicola and MacLaren, Linda and MacLeod, Nicholas and Glegg, Martin and Lamb, Gillian and Houston, Peter and Carruthers, Ross and Grocutt, Laura and Valentine, Ronan (2024) Adaptive radiotherapy for muscle invasive bladder cancer: a retrospective audit of two bladder filling protocols. Radiation Oncology, 19 (1): 92. ISSN 1748-717X
See full publications listLaverick, Nicola
Author
Briceño Guel, Diana Nohemi and Laverick, Nicola and MacLaren, Linda and MacLeod, Nicholas and Glegg, Martin and Lamb, Gillian and Houston, Peter and Carruthers, Ross and Grocutt, Laura and Valentine, Ronan (2024) Adaptive radiotherapy for muscle invasive bladder cancer: a retrospective audit of two bladder filling protocols. Radiation Oncology, 19 (1): 92. ISSN 1748-717X
See full publications listMacLaren, Linda
Author
Briceño Guel, Diana Nohemi and Laverick, Nicola and MacLaren, Linda and MacLeod, Nicholas and Glegg, Martin and Lamb, Gillian and Houston, Peter and Carruthers, Ross and Grocutt, Laura and Valentine, Ronan (2024) Adaptive radiotherapy for muscle invasive bladder cancer: a retrospective audit of two bladder filling protocols. Radiation Oncology, 19 (1): 92. ISSN 1748-717X
See full publications listMacLeod, Nicholas
Author
Thompson, Joshua J. and MacLeod, Nicholas and Will, Sarah and O'Rourke, Fraser and McGovern, Josh and Roxburgh, Campbell and Edwards, Joanne and Dolan, Ross D. and McMillan, Donald C. (2025) The prognostic value of a laboratory cachexia score (LCAS) defined by LDH, CRP and albumin in patients with advanced lung cancer. BMC Cancer, 25: 543. ISSN 1471-2407
Briceño Guel, Diana Nohemi and Laverick, Nicola and MacLaren, Linda and MacLeod, Nicholas and Glegg, Martin and Lamb, Gillian and Houston, Peter and Carruthers, Ross and Grocutt, Laura and Valentine, Ronan (2024) Adaptive radiotherapy for muscle invasive bladder cancer: a retrospective audit of two bladder filling protocols. Radiation Oncology, 19 (1): 92. ISSN 1748-717X
See full publications listGlegg, Martin
Author
Briceño Guel, Diana Nohemi and Laverick, Nicola and MacLaren, Linda and MacLeod, Nicholas and Glegg, Martin and Lamb, Gillian and Houston, Peter and Carruthers, Ross and Grocutt, Laura and Valentine, Ronan (2024) Adaptive radiotherapy for muscle invasive bladder cancer: a retrospective audit of two bladder filling protocols. Radiation Oncology, 19 (1): 92. ISSN 1748-717X
See full publications listLamb, Gillian
Author
Briceño Guel, Diana Nohemi and Laverick, Nicola and MacLaren, Linda and MacLeod, Nicholas and Glegg, Martin and Lamb, Gillian and Houston, Peter and Carruthers, Ross and Grocutt, Laura and Valentine, Ronan (2024) Adaptive radiotherapy for muscle invasive bladder cancer: a retrospective audit of two bladder filling protocols. Radiation Oncology, 19 (1): 92. ISSN 1748-717X
See full publications listHouston, Peter
Author
Williamson, Aoife and Houston, Peter and Paterson, Jennifer and Chalmers, Anthony J. and McLoone, Philip and Fullerton, Natasha and Foo, Sin Yee and James, Allan and Nowicki, Stefan (2024) Dosimetric comparison of hippocampal sparing technologies in patients with low grade glioma. Neuro-Oncology Advances, 6 (1): vdae131. ISSN 2632-2498
Briceño Guel, Diana Nohemi and Laverick, Nicola and MacLaren, Linda and MacLeod, Nicholas and Glegg, Martin and Lamb, Gillian and Houston, Peter and Carruthers, Ross and Grocutt, Laura and Valentine, Ronan (2024) Adaptive radiotherapy for muscle invasive bladder cancer: a retrospective audit of two bladder filling protocols. Radiation Oncology, 19 (1): 92. ISSN 1748-717X
See full publications listCarruthers, Ross
Author
Briceño Guel, Diana Nohemi and Laverick, Nicola and MacLaren, Linda and MacLeod, Nicholas and Glegg, Martin and Lamb, Gillian and Houston, Peter and Carruthers, Ross and Grocutt, Laura and Valentine, Ronan (2024) Adaptive radiotherapy for muscle invasive bladder cancer: a retrospective audit of two bladder filling protocols. Radiation Oncology, 19 (1): 92. ISSN 1748-717X
Girasol, Mark John and Krasilnikova, Marija and Marques, Catarina A. and Damasceno, Jeziel D. and Lapsley, Craig and Lemgruber, Leandro and Burchmore, Richard and Beraldi, Dario and Carruthers, Ross and Briggs, Emma M. and McCulloch, Richard (2023) RAD51-mediated R-loop formation acts to repair transcription associated DNA breaks driving antigenic variation in Trypanosoma brucei. Proceedings of the National Academy of Sciences of the United States of America, 120 (48): e230930612. ISSN 0027-8424
See full publications listGrocutt, Laura
Author
Briceño Guel, Diana Nohemi and Laverick, Nicola and MacLaren, Linda and MacLeod, Nicholas and Glegg, Martin and Lamb, Gillian and Houston, Peter and Carruthers, Ross and Grocutt, Laura and Valentine, Ronan (2024) Adaptive radiotherapy for muscle invasive bladder cancer: a retrospective audit of two bladder filling protocols. Radiation Oncology, 19 (1): 92. ISSN 1748-717X
See full publications listValentine, Ronan
Author
Briceño Guel, Diana Nohemi and Laverick, Nicola and MacLaren, Linda and MacLeod, Nicholas and Glegg, Martin and Lamb, Gillian and Houston, Peter and Carruthers, Ross and Grocutt, Laura and Valentine, Ronan (2024) Adaptive radiotherapy for muscle invasive bladder cancer: a retrospective audit of two bladder filling protocols. Radiation Oncology, 19 (1): 92. ISSN 1748-717X
See full publications listAvailable under License Creative Commons Attribution.
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