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A feasibility study for the introduction of micro-enema to improve organ consistency in patients receiving radiotherapy for urinary bladder cancer

Published online by Cambridge University Press:  20 June 2017

D. Hutton ,
J. Callender ,
N. Hutton ,
H. Wong  and
I. Syndikus
D. Hutton*
Affiliation:
The Clatterbridge Cancer Centre NHS FT, Wirral, UK
J. Callender
Affiliation:
The University of Liverpool, Liverpool, UK
N. Hutton
Affiliation:
The Clatterbridge Cancer Centre NHS FT, Wirral, UK
H. Wong
Affiliation:
The Clatterbridge Cancer Centre NHS FT, Wirral, UK
I. Syndikus
Affiliation:
The Clatterbridge Cancer Centre NHS FT, Wirral, UK
*
Correspondence to: Daniel Hutton, Transforming Cancer Care, Clatterbridge Centre for Oncology NHS Foundation Trust, Clatterbridge Road, Bebbington, Wirral, CH63 4JY, UK. Tel: 0151 556 5854. E-mail: [email protected]
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Abstract

Aims

The aim of the study was to assess the effect on rectal consistency, of introducing a micro-enema in the preparation of patients receiving radiotherapy treatment of urinary bladder cancer.

Materials and methods

The treatment cone beam computed tomography (CBCT) images from patients receiving radiotherapy for bladder cancer were retrospectively assessed. CBCT datasets from nine patients treated without rectal preparation (97 CBCT), and 13 patients (134 CBCT) treated following micro-enema use before planning and treatment were evaluated. CBCT were compared with the planning computed tomography for rectal status, rectal diameter and presence of gas.

Results

Reproducibility of an empty rectum was achieved in 70% of treatment fractions delivered using an enema protocol compared with 33% of fractions delivered without preparation. In total, 10% of fractions were delivered with the presence of faeces or faeces and gas, compared with 46% of fractions for the non-intervention group. Enemas did not affect the proportion of fractions delivered with gas, however, where gas was present, 65% of CBCT fractions had <5% gas for patients using enemas compared with 32% without.

Findings

The use of a micro-enema before planning scan and each fraction was well tolerated and proved effective in managing and reducing inter-fraction variations in rectal volume and contents.

Keywords

adaptivebladder cancerenemaradiotherapy
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 17 , Issue 1 , March 2018 , pp. 20 - 28
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Copyright
© Cambridge University Press 2017 

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