open access

Vol 21, No 1 (2016)
Original research articles
Published online: 2016-01-01
Submitted: 2015-02-27
Get Citation

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 Skóra, Bogumiła Szyszka-Charewicz, Jerzy Jakubowicz
DOI: 10.1016/j.rpor.2015.09.001
·
Rep Pract Oncol Radiother 2016;21(1):31-36.

open access

Vol 21, No 1 (2016)
Original research articles
Published online: 2016-01-01
Submitted: 2015-02-27

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.

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.

Get Citation

Keywords

Muscle-invasive bladder cancer; Radical conservative treatment; Radiotherapy; Concomitant boost

About this article
Title

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

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 21, No 1 (2016)

Pages

31-36

Published online

2016-01-01

DOI

10.1016/j.rpor.2015.09.001

Bibliographic record

Rep Pract Oncol Radiother 2016;21(1):31-36.

Keywords

Muscle-invasive bladder cancer
Radical conservative treatment
Radiotherapy
Concomitant boost

Authors

Jadwiga Nowak-Sadzikowska
Tomasz Skóra
Bogumiła Szyszka-Charewicz
Jerzy Jakubowicz

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: journals@viamedica.pl