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Published on: August 19, 2025
846
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))
|August 12, 2019
Summary
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.
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.
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