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Updated: Jan 21, 2026

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The Intensity-Modulated Pelvic Node and Bladder Radiotherapy (IMPART) Trial: A Phase II Single-Centre Prospective

M P Tan1, V Harris2, K Warren-Oseni3

  • 1Academic Radiotherapy Unit, Institute of Cancer Research, Sutton, Surrey, UK; The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK.

Clinical Oncology (Royal College of Radiologists (Great Britain))
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Summary
This summary is machine-generated.

Intensity-modulated radiotherapy (IMRT) is a feasible treatment for node-positive bladder cancer (NPBC), showing acceptable toxicity and reduced pelvic recurrence. Further strategies are needed to improve long-term patient survival.

Keywords:
Bladder cancerIMRTpelvic nodesradiotherapy

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Area of Science:

  • Radiation Oncology
  • Urologic Oncology
  • Clinical Trials

Background:

  • Node-positive bladder cancer (NPBC) has a poor prognosis, with limited data on radiotherapy use.
  • Conventional whole-pelvis radiotherapy raises toxicity concerns for NPBC patients.
  • Intensity-modulated radiotherapy (IMRT) offers a potential solution for treating pelvic nodes and bladder.

Purpose of the Study:

  • To assess the feasibility of IMRT for bladder and pelvic nodes in NPBC and high-risk node-negative bladder cancer (NNBC).
  • To evaluate toxicity profiles and survival outcomes of IMRT in this patient cohort.

Main Methods:

  • Prospective, single-centre, phase II study (IMPART trial).
  • 38 patients with NPBC or high-risk NNBC treated with IMRT.
  • Primary endpoint: meeting predetermined dose constraints; secondary endpoints: toxicity, relapse-free survival, overall survival.

Main Results:

  • IMRT delivery was feasible in 97% of patients.
  • Grade 3 acute GI and GU toxicity rates were 5.4% and 20.6%, respectively.
  • 5-year pelvic relapse-free survival was 26%, and 5-year overall survival was 34%.

Conclusions:

  • IMRT is feasible for NPBC and high-risk NNBC, with low toxicity and pelvic nodal recurrence.
  • Long-term disease control may be achievable in a subset of patients.
  • Improved outcomes require strategies addressing both local recurrence and distant metastases.