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Involved-field irradiation for elderly bladder cancer patients
Hongwei Li1, Wei Chen2, Jinbo Ma2
1Department of Oncology, School of Medicine, Qingdao University, Qingdao, P.R. of China; Department of Radiation Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, P.R. of China.
Current Problems in Cancer
|August 16, 2018
Summary
In elderly bladder cancer patients, involved-field irradiation (IFI) showed decreased acute toxicity compared to elective nodal irradiation (ENI) without increasing local failure rates. Further clinical trials are needed to confirm these findings for adjuvant radiation therapy.
Area of Science:
- Oncology
- Radiation Oncology
- Geriatric Oncology
Background:
- Adjuvant radiation therapy is a common treatment for bladder cancer.
- Clinical target volume significantly influences treatment-related toxicity.
- Optimizing radiation techniques is crucial for elderly patients with bladder cancer.
Purpose of the Study:
- To compare treatment failures between involved-field irradiation (IFI) and elective nodal irradiation (ENI) in elderly bladder cancer patients.
- To assess differences in treatment-related toxicity and survival outcomes between IFI and ENI.
- To evaluate the feasibility of IFI in this patient population.
Main Methods:
- Retrospective analysis of 92 elderly bladder cancer patients treated between 2010 and 2014.
- Patients received adjuvant radiotherapy using either IFI or ENI after transurethral resection or partial cystectomy.
- Outcomes including acute toxicity, local progression-free survival, and 3-year overall survival were analyzed using chi-square tests, Kaplan-Meier method, and Cox analysis.
Main Results:
- A statistically significant difference in acute toxicity was observed between IFI (45.23%) and ENI (72.00%) (P=0.008).
- No significant differences were found in 3-year overall survival rates (45.20% vs 48.00%, P=0.860) or local progression-free survival (24.98 vs 34.30 months, P=0.729).
- IFI was associated with reduced acute toxicity without compromising local control.
Conclusions:
- Involved-field irradiation (IFI) is a feasible adjuvant radiotherapy option for elderly bladder cancer patients.
- IFI demonstrates a reduction in acute toxicity compared to elective nodal irradiation (ENI).
- Larger clinical trials are warranted to validate these findings and further support the use of IFI.
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