The Significance of Portable Bladder Scanner in Radiotherapy for Locally Advanced Cervical Cancer Patients

Abstract

Comparatively observe the treatment effect and side effect difference between the use and non-use of portable bladder scanner in the external beam radiotherapy(RT) of locally advanced cervical cancer patients. Forty-one female patients with locally advanced cervical cancer from Aug 2014 to Aug 2016 at Chongqing Cancer Hospital, were randomly divided into two groups: experiment group (EG) in which portable bladder scanner (BS) was used, and control group (CG) in which oral protocol (OP) was used. Both groups were treated with the same plan(radiotherapy with or without concomitant chemotherapy) .BS was used in EG before RT to keep the bladder volume(BV) almost the same with the basal level, and OP was used in CG to keep the BV based on the patients’ urine. The cone-beam CT (CBCT) was then followed by BS with a delivery frequency of 2-3 times/week. The side effects (CTCAE v4.0) and clinical efficacy (WHO) were evaluated in both groups. The average change of BV(BVCBCT - BVplan-CT) in EG is 41.2±169.6ml, and in CG is -123.6±186.1ml. The difference between the two groups is statistically significant (P<0.05). The incontinence, cystitis, frequency/urgency and enterocolitis were observed to be lower in EG than that in CG(8.3%, 0.0%, 16.7%, 12.5% V.S 17.6%, 5.9%, 35.3%, 23.5%), but this difference between the two groups is not significant (P＞0.05). The incidence of diarrhea is very similar (EG 20.8% V.S CG 23.5%). The incidence and grade of incontinence, cystitis and frequency/urgency shows a significant correlation with the decrease of BVCBCT (based on BVplan-CT) just in CG (R=0.572, 0.493 and 0.721,respectively,all the P<0.05). The median follow-up(FU) was 51 (19-55) months. The median FU was 51 (19-55) months. The short-term survival rate, long-term survival rate, metastasis rate and recurrence rate of EG and CG were 100%, 79.2%, 16.7%, 4.2% and 100%, 70.6%, 29.4%, 0%, respectively. There was no significant difference between these rates of the two groups(P＞0.05). The application of BS in radiotherapy for locally advanced cervical cancer patients can maintain the stability of bladder volume better and reduce the incidence and grade of urinary tract side effects. No effect on the effective rate and the overall survival has been observed.