Radiation therapy for transitional cell bladder carcinoma. A ten-year experience

Area of Science:

• Oncology
• Radiation Oncology
• Urologic Oncology

Background:

• Transitional cell bladder carcinoma is a significant oncologic diagnosis.
• Curative treatment options include radiation therapy and surgery.
• Patient factors, such as obstructive uropathy, may impact treatment outcomes.

Purpose of the Study:

• To evaluate the efficacy of radiation therapy (RT) alone versus combined radiation and surgery (RT + S) for transitional cell bladder carcinoma.
• To assess the impact of obstructive uropathy on survival.
• To analyze survival rates, pelvic control, and patterns of failure.

Main Methods:

• Retrospective analysis of 185 patients with transitional cell bladder carcinoma treated between 1969 and 1979.
• Patients received either radical RT (n=147) or RT + S (n=38).
• Data collected included treatment modality, presence of obstructive uropathy, survival, disease-free survival, and complications.

Main Results:

• Overall five-year disease-free survival was 30% for radical RT and 53% for RT + S.
• Patients with obstructive uropathy had a five-year survival of 18% compared to 50% without.
• Preoperative irradiation resulted in downstaging in 40% of cases, with 27% showing no evidence of tumor and excellent survival.

Conclusions:

• Combined radiation and surgery (RT + S) demonstrates superior survival outcomes for transitional cell bladder carcinoma compared to radiation alone.
• Obstructive uropathy is a critical prognostic factor negatively impacting survival.
• Preoperative irradiation shows promise for tumor downstaging and improved survival in select patients.