[Exclusive radiotherapy in bladder cancer]

The indications for treatment of superficial and infiltrating tumors of the urinary bladder by radiotherapy alone are analyzed.

The records of 468 patients treated at the Oncological Radiotherapy Department of the Clinica Puerta de Hierro in Madrid and data from the literature were reviewed.

Radiotherapy continues to be a conservative alternative to radical cystectomy in infiltrating bladder cancer. Although the survival rates are slightly lower than those of the more recent series of patients treated by cystectomy, the cystectomy series report the results of retrospective studies in patients that were not randomized and with a bias in patient selection. The best results are obtained in young adult patients with T2-T3a tumors and no ureteral obstruction. In superficial bladder tumors, radiotherapy might be useful in recurrences of T1G3 managed conservatively. Its value as an adjuvant therapy has yet to be defined and is currently under study. Palliative radiotherapy for bladder cancer achieves satisfactory results in the control of hematuria and pain.

Radiotherapy is a radical therapeutic option in infiltrating tumor of the bladder that must be considered as an alternative to radical cystectomy, perhaps within the context of current strategies of combination radio and chemotherapy.