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Updated: Nov 6, 2025
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An Orthotopic Bladder Tumor Model and the Evaluation of Intravesical saRNA Treatment
Published on: July 28, 2012
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Adjuvant and Neoadjuvant Radiation Therapy for Locally Advanced Bladder Cancer.
B C Baumann1, M S Zaghloul2, P Sargos3
1Department of Radiation Oncology, Washington University in St. Louis, St. Louis, MO, USA; Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA.
Clinical Oncology (Royal College of Radiologists (Great Britain))
|May 11, 2021
Summary
Adjuvant radiotherapy may improve outcomes for urothelial carcinoma patients after radical cystectomy. Combining radiation therapy with chemotherapy shows promise in reducing local recurrences and improving survival rates.
Area of Science:
- Uro-oncology
- Radiation Oncology
- Medical Oncology
Background:
- Local-regional failure is a significant challenge for patients with advanced urothelial carcinoma after radical cystectomy.
- Chemotherapy alone has not effectively reduced local-regional recurrences in prospective trials.
- Salvage treatment for local failures post-cystectomy is often difficult and unsuccessful.
Purpose of the Study:
- To review the problem of local-regional failure after cystectomy for urothelial carcinoma.
- To identify patient subgroups who may benefit from adjuvant radiotherapy.
- To discuss patterns of pelvic failure, technical aspects of radiation treatment, and review relevant literature.
Main Methods:
- Review of modern literature on local-regional failure after cystectomy.
- Analysis of evidence from trials investigating radiation therapy plus chemotherapy.
- Identification of high-risk patient characteristics and patterns of pelvic failure.
Main Results:
- Promising evidence suggests radiation therapy plus chemotherapy can significantly reduce local recurrences compared to chemotherapy alone.
- Improved local-regional control may translate to better disease-free and overall survival with acceptable toxicity.
- National Comprehensive Cancer Network guidelines now include postoperative radiotherapy as an option for patients with ≥pT3 disease.
Conclusions:
- Adjuvant radiotherapy should be considered for patients with locally advanced urothelial carcinoma, particularly those with positive margins or squamous cell carcinoma.
- Improved understanding of failure patterns and patient risk stratification supports the use of adjuvant radiotherapy.
- Radiation therapy combined with chemotherapy offers a potential strategy to improve outcomes in this challenging patient population.
