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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
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Hypofractionation: less is more?

Neethu Billy Graham Mariam1, Yee Pei Song1,2, Nuradh Joseph3

  • 1Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK.

Oncotarget
|August 26, 2021
PubMed
Summary
This summary is machine-generated.

Hypofractionated radiotherapy is non-inferior to conventional radiotherapy for muscle invasive bladder cancer (MIBC). This bladder cancer treatment offers superior locoregional control, supporting its use in clinical practice.

Keywords:
BC2001BCONbladder cancerhypofractionation

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Urologic Oncology

Background:

  • Muscle invasive bladder cancer (MIBC) presents a poor prognosis, with one-third of patients diagnosed at this advanced stage.
  • Current management guidelines include radical cystectomy or bladder-preserving strategies involving radiotherapy with radiosensitization.
  • Both conventional (64 Gy/32 fractions) and hypofractionated (55 Gy/20 fractions) radiotherapy are UK standard care options for MIBC.

Purpose of the Study:

  • To evaluate the non-inferiority of a hypofractionated radiotherapy schedule compared to a conventional regimen in patients with locally advanced bladder cancer.
  • To assess the efficacy and safety of different radiotherapy fractionation schedules for MIBC.

Main Methods:

  • A meta-analysis of individual patient data from two UK multicentre phase 3 trials was conducted.
  • The study compared outcomes between patients treated with hypofractionated versus conventional radiotherapy schedules.
  • Locoregional control and survival data were analyzed to determine non-inferiority and treatment effectiveness.

Main Results:

  • The hypofractionated radiotherapy regimen was confirmed to be non-inferior to the conventional schedule for muscle invasive bladder cancer.
  • Superior locoregional control was observed with the hypofractionated regimen.
  • The findings support the efficacy of hypofractionation in improving bladder cancer treatment outcomes.

Conclusions:

  • Hypofractionated radiotherapy is a viable and effective alternative to conventional fractionation for MIBC.
  • The superior locoregional control associated with hypofractionation warrants its consideration in clinical practice.
  • Further discussion includes radiobiology, systemic therapies, radiosensitization, and socioeconomic benefits of hypofractionated radiotherapy.