Abstract
BACKGROUND AND OBJECTIVE: This study looked into how bladder volume affected clinical outcomes in individuals with cervical cancer after external radiation therapy as well as the radiation dosage received by organs at risk. METHODS: A retrospective cohort analysis was carried out on 142 patients with cervical cancer who underwent postoperative radiotherapy between January 2017 and September 2020. Based on differences in bladder capacities, these patients were divided into three groups: Group A (V ≤ 300 ml), Group B (300500 ml). The purpose of the study was to determine how different bladder volumes affected the radiation doses that the rectum (V30, V40, V50, D2cm(3)), small intestine (V30, V40, V50, D2cm(3)), and bladder (V30, V40, V50, D2cm(3)) got. KEY FINDINGS AND LIMITATIONS: The median age was 53 years, and the usual follow-up period was 48 months. Group A had considerably higher values for bladder V30 and V40 (73.83 ± 11.56% and 47.21 ± 6.953%, respectively; p = 0.0130 and p = 0.0033). The results of the V40 measurement in the small intestine were also highest in group A (37.79 ± 10.66%; p = 0.0151), while in the bladder and rectum (57.85 ± 4.042 Gy, 51.35 ± 3.627 Gy; p = 0.0006 and p = 0.0211, respectively), group C had the highest values. Among the groups, group B exhibited a notably decreased incidence of radiation cystitis (p = 0.0396). CONCLUSIONS AND CLINICAL IMPLICATIONS: For patients with cervical cancer undergoing external irradiation, a bladder volume of 300ml to 500ml is ideal. ADVANCING PRACTICE WHAT DOES THE STUDY ADD? This study identifies an optimal bladder volume range of 300-500 mL during external beam radiotherapy for cervical cancer. Compared to smaller or larger volumes, this range reduces radiation exposure to critical organs, leading to fewer side effects. These findings provide practical, evidence-based guidance for bladder filling protocols to improve patient outcomes. PATIENT SUMMARY: For patients receiving radiation therapy for cervical cancer, keeping the bladder moderately full (about 300-500 mL) during treatment may help protect the bladder and bowel from radiation damage. This simple measure was linked to fewer mild side effects, such as bladder irritation or diarrhea. Patients can discuss with their doctors how to maintain a comfortable bladder volume to potentially improve their quality of life during and after treatment.