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Intensity modulated radiotherapy for elderly bladder cancer patients
Chen-Hsi Hsieh1, Shiu-Dong Chung, Pei-Hui Chan
1Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan.
Radiation Oncology (London, England)
|June 18, 2011
Summary
Intensity-modulated radiotherapy (IMRT) and helical tomotherapy (HT) offer effective bladder cancer treatment for elderly patients, showing improved survival and progression-free survival. Treatment planning and completion time significantly impact overall survival rates.
Area of Science:
- Oncology
- Radiation Oncology
- Geriatric Oncology
Background:
- Elderly patients with bladder cancer require specialized treatment approaches.
- Intensity-modulated radiotherapy (IMRT) and helical tomotherapy (HT) are advanced radiation techniques.
- Evaluating these techniques in elderly populations is crucial for optimizing care.
Purpose of the Study:
- To review experience and evaluate treatment planning for elderly bladder cancer patients using IMRT and HT.
- To compare the efficacy and safety of IMRT and HT in this demographic.
- To assess the impact of treatment parameters on patient outcomes.
Main Methods:
- Retrospective review of 19 elderly patients (median age 80) with bladder cancer treated between 2006-2009.
- Patients were divided into IMRT (n=9) and HT (n=10) groups, receiving 64.8 Gy with or without chemotherapy.
- Conventional 4-field "box" pelvic radiation therapy (2DRT) plans were used for comparison.
Main Results:
- Median survival was 21 months. Two-year overall survival (OS) was 26.3% for IMRT vs. 37.5% for HT.
- Disease-free survival was 58.3% (IMRT) vs. 83.3% (HT). Locoregional progression-free survival (LRPFS) was 87.5% (IMRT) vs. 83.3% (HT).
- Higher T-stage and RT completion time >8 weeks were associated with poorer OS (p=0.046 and p=0.004, respectively).
Conclusions:
- IMRT and HT provide good LRPFS with tolerable toxicity in elderly patients with invasive bladder cancer.
- Both IMRT and HT offer superior dosimetry and organ-sparing compared to 2DRT, with HT demonstrating better sparing.
- Tumor T category and radiation therapy completion time are significant factors influencing overall survival.
