[Palliative radiotherapy of bladder cancer]

To present the results of a retrospective study which was conducted to analyze the utility of palliative radiotherapy in advanced bladder cancer and to evaluate the results of the different fractionation regimens in relation to the response rate and its duration, overall survival and side effects.

During a 10-year period, 56 patients with locally advanced bladder cancer received palliative external radiotherapy for the symptoms arising from their condition. The following fractionation schedules were mainly used: conventional irradiation with 40-60 Gy in 22-23 fractions in 20 cases and a low dose of 30 Gy in 10 fractions in 23. Other fractionation modalities were used in 6 patients. Eight patients received radiotherapy for symptomatic relief of pain from bony metastasis.

28 patients (50%) achieved complete remission of the initial symptoms and 15 (26.8%) showed a partial remission. The mean duration of response was 4 months (range 1-108). The overall uncorrected survival rate was 26.7% at one year (15 patients), 12.5% at three years (7 patients) and 7.1% at five years (4 patients), for a mean survival of 7.5 months (range 1-109).

Radiotherapy is effective in the management of symptoms, specially hematuria, in patients with advanced carcinoma of the urinary bladder. Short fractionation regimens that achieve the same therapeutic results are preferred since visits to the hospital or long hospitalization can be avoided, thereby improving patient quality of life.