Image-Guided Radiotherapy and Chemotherapy in Gynaecological Cancer

Bladder filling and bowel volume

⚫ Full bladder versus empty bladder decreases volume of bowel irradiated to a significant dose

⚫ Avoid very large filling (>300ml)*

⚫ Example drinking protocol: 

450-500ml 1 hour prior to planning CT scan and to each treatment

⚫ Reproducibility of bladder filling?  Significant variation  Main purpose is to push bowel away!

*Eminowicz et al, Understanding the impact of pelvic organ motion on dose delivered to target volumes during IMRT for cervical cancer. Radiother Oncol 2017;122:116–21