Organ preservation by external beam and afterloading interstitial radiation in patients with muscle infiltrating bladder cancer

In several European cancer centers, the combination of external beam and interstitial radiotherapy with the aim of bladder preservation is standard treatment in a selected group of patients with muscle-infiltrating bladder cancer. Three case reports are presented. The published local control rates at 5 years vary from 64% to 88% and the 5-year overall and disease-free survival range from 47% to 66% and from 62% to 81%, respectively. It is concluded that this approach is successful in preserving the bladder. Conditions for good results are careful selection of patients, excellent cooperation between urologist and radiation oncologist, and modern brachytherapy facilities.