Vol 21, No 1 (2016)
Original research articles
Published online: 2016-01-01

open access

Page views 177
Article views/downloads 196
Get Citation

Connect on Social Media

Connect on Social Media

Muscle-invasive bladder cancer treated with TURB followed by concomitant boost with small reduction of radiotherapy field with or without of chemotherapy

Jadwiga Nowak-Sadzikowska, Tomasz Skóra1, Bogumiła Szyszka-Charewicz1, Jerzy Jakubowicz1
DOI: 10.1016/j.rpor.2015.09.001
Rep Pract Oncol Radiother 2016;21(1):31-36.

Abstract

Aim

To evaluate the clinical outcome and toxicity of the treatment of muscle-invasive bladder cancer (MIBC) that combined transurethral resection of bladder tumor (TURB) with “concomitant boost” radiotherapy delivered over a shortened overall treatment time of 5 weeks, with or without concurrent chemotherapy.

Background

Local control of MIBC by bladder-sparing approach is unsatisfactory. In order to improve the effectiveness of radiotherapy, we have designed a protocol that combines TURB with a non-conventionally fractionated radiotherapy “concomitant boost”.

Materials and methods

Between 2004 and 2010, 73 patients with MIBC cT2-4aN0M0, were treated with “concomitant boost” radiotherapy. The whole bladder with a 2–3[[ce:hsp sp="0.25"/]]cm margin was irradiated with fractions of 1.8[[ce:hsp sp="0.25"/]]Gy to a dose of 45[[ce:hsp sp="0.25"/]]Gy, with a “concomitant boost” to the bladder with 1–1.5[[ce:hsp sp="0.25"/]]cm margin, during the last two weeks of treatment, as a second fraction of 1.5[[ce:hsp sp="0.25"/]]Gy, to a total dose of 60[[ce:hsp sp="0.25"/]]Gy. Radiochemotherapy using mostly cisplatin was delivered in 42/73(58%) patients, 31/73(42%) patients received radiotherapy alone.

Results

Acute genitourinary toxicity of G3 was scored in 3/73(4%) patients. Late gastrointestinal toxicity higher than G2 and genitourinary higher than G3 were not reported. Complete remission was achieved in 48/73(66%), partial remission in 17/73(23%), and stabilization disease in 8/73(11%) patients. Three- and five-year overall, disease specific and invasive locoregional disease-free survival rates were 65% and 52%, 70% and 59%, 52% and 43%, respectively.

Conclusions

An organ-sparing approach using TURB followed by radio(chemo)therapy with “concomitant boost” in patients with MIBC allows to obtain long-term survival with acceptable toxicity.

Article available in PDF format

View PDF Download PDF file



Reports of Practical Oncology and Radiotherapy