Reducing Radiation Dose to Pelvic Small Bowel in Cervical Cancer Patients Treated with Ir-192 Intracavitary Brachytherapy by Using Urinary Bladder Distension
Jirasak Sukhaboon MD*, Kanjana Shotelersuk MD*, Prasert Lertsanguansinchai MD*,Chonlakiet Khorprasert MD*
Affiliation : *Division of Radiation Oncology, Department of Radiology. Faculty of Medicine, Chulongkorn University
Objectives: Several techniques and devices have been used in an attempt to minimize radiation dose to
gastrointestinal tract while giving pelvic radion. We evaluated the effect of urinary bladder dision to
displace pelvic small bowel out of intracavitary brachytherapy field to minimize radiation dose to small bowel
in cervical cancer patients.
Material and Method: Eleven cervical cancer patients who received Ir-192 intracavitary brachytherapy with
tandem and transverse ovoids were included in this study. Oral contrast material was used to visualize pelvic
small bowel. Urinary bladder was distended by injection 125-200 ml. normal saline solution. Pelvic radio~
graph, anteroposterior and lateral view, was performed before and after bladder distention for brachytherapy
treatment planning and comparing radiation dose at small bowel.
Results: The average maximum radiation dose at small bowel before and after bladder distension were
3,123cGy and 1,998cGy respectively. The summation of small bowel dose was reduced 54.17% (p = 0.002).
Conclusion: Urinary bladder distension could effectively displace pelvic small bowel and reduce radia-
tion dose to small bowel from Ir-192 intracavitary brachytherapy in cervical cancer patients.
Keywords : Urinary bladder distension, Small bowel, Brachytherapy, Cervical cancer
