@Article{info:doi/10.2196/68179,
author="Rades, Dirk
and K{\"u}ter, Jan-Dirk
and von Staden, Michael
and Al-Salool, Ahmed
and Janssen, Stefan
and Timke, Carmen
and Duma, Marciana Nona
and Bartscht, Tobias
and Vesterg{\aa}rd Madsen, Christine
and Kristiansen, Charlotte
and Cremers, Florian",
title="A Reminder App to Optimize Bladder Filling During Radiotherapy for Patients With  Prostate Cancer (REFILL-PAC): Protocol for a Prospective Trial",
journal="JMIR Res Protoc",
year="2025",
month="Apr",
day="8",
volume="14",
pages="e68179",
keywords="prostate cancer; external beam radiation therapy; radiation toxicity; bladder filling; mobile app",
abstract="Background: Many patients with nonmetastatic prostate cancer receive radiotherapy, which may be associated with acute cystitis, particularly if the volume of the urinary bladder is small. Three studies showed bladder volumes <200 ml or <180 ml to be associated with increased urinary toxicity. Therefore, it is important to maintain bladder volumes greater than 200 ml during as many radiation fractions as possible. Several studies investigated drinking protocols, where patients were asked to drink a certain amount of water prior to radiotherapy sessions. This may require considerable discipline from the patients, who are predominantly older adults. Adherence to a drinking protocol may be facilitated by a mobile app that reminds patients to drink water prior to each radiation session. This study investigates the effect of such an app on bladder filling status in patients with prostate cancer undergoing external beam radiotherapy (EBRT) alone. Objective: The primary goal of this study is to evaluate the impact of an app that reminds patients irradiated for prostate cancer to drink 300 ml of water prior to each radiotherapy session on the number of fractions with bladder volumes <200 ml during the radiotherapy course. Methods: This ongoing phase 2 aims to recruit 28 patients treated with EBRT alone for nonmetastatic prostate cancer. Radiotherapy will be administered using normo-fractionation, with doses ranging from 70 to 80 Gy in 35 to 40 fractions of 2 Gy, preferably with volumetric-modulated arc therapy (VMAT). Treatment volumes include the prostate with or without the seminal vesicles. Results: Recruitment for this trial will start in March 2025 and is planned to be completed in October 2026. The study is scheduled to conclude in December 2026. Conclusions: This trial is the first to evaluate the impact of a reminder app on the number of radiotherapy fractions with bladder volumes <200 ml in patients undergoing irradiation for localized prostate cancer. Trial Registration: Clinicaltrials.gov NCT06653751; https://clinicaltrials.gov/show/NCT06653751 International Registered Report Identifier (IRRID): PRR1-10.2196/68179 ",
issn="1929-0748",
doi="10.2196/68179",
url="https://www.researchprotocols.org/2025/1/e68179",
url="https://doi.org/10.2196/68179"
}