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Brachytherapy with iridium-192 for bladder cancer
H Van Poppel1, Y Lievens, E Van Limbergen
1Department of Urology and Radiotherapy, Katholieke Universiteit Leuven, Belgium.
European Urology
|April 15, 2000
Summary
Radical cystectomy for invasive bladder cancer can be avoided. Combining surgery with interstitial radiation therapy offers a safe and effective bladder preservation option, achieving long-term remission in select patients.
Area of Science:
- Oncology
- Radiation Oncology
- Surgical Oncology
Background:
- Radical cystectomy is standard for invasive bladder cancer but significantly impacts quality of life.
- Bladder preservation strategies aim to maintain quality of life without compromising oncological outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of a bladder preservation approach combining surgery and interstitial radiotherapy for invasive bladder cancer.
- To assess the feasibility of the afterloading technique with iridium-192 for interstitial brachytherapy.
Main Methods:
- Twenty-eight patients with invasive bladder cancer received preoperative external beam radiotherapy followed by surgical exploration and partial cystectomy.
- Interstitial iridium-192 brachytherapy was delivered using an afterloading technique.
- Patients underwent close follow-up including urine cytology, cystoscopy, and CT scans.
Main Results:
- 57% of patients achieved no evidence of disease at long-term follow-up.
- 18% of patients died from non-cancer-related causes with no tumor recurrence.
- 25% of patients experienced tumor progression.
Conclusions:
- Interstitial radiation therapy, combined with surgery, can achieve long-term complete remission for select patients with small, solitary invasive bladder tumors.
- The afterloading brachytherapy technique is safe and effective.
- Careful patient selection is crucial for successful outcomes in bladder preservation therapy.