2017_IGRT course book

Significant shape change

Bladder too small

Small plan provides appropriate coverage of bladder but normal tissue sparing from high dose region compromised

Appropriate to consider treatment with small plan

Requires clinical review prior to next fraction. Assessment :- i) general hydration status ii) development of urinary toxicity requiring intervention (preventing from appropriate holding) iii) increasing time to image acquisition>30mins and, or iv) increasing volume of fluids in drinking protocol