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How Small Can We Go? Partial Bladder Radiation Therapy and Brachytherapy
Jenna M Kahn1, Geert A H J Smits2, Bernard J Oosterveld3
1Department of Radiation Medicine, Oregon Health and Science University, Portland, OR.
Seminars in Radiation Oncology
|December 14, 2022
Summary
Organ preservation for muscle-invasive bladder cancer (MIBC) can be achieved with trimodality therapy. This review explores optimizing radiation techniques like brachytherapy and partial bladder external beam radiation for better outcomes.
Area of Science:
- Oncology
- Radiation Oncology
- Urology
Background:
- Muscle-invasive bladder cancer (MIBC) management often involves radical cystectomy, but organ preservation strategies are gaining traction.
- Trimodality therapy, including transurethral resection and radiation therapy, is a standard approach for MIBC, offering high local control and survival rates.
- The primary goal of organ preservation is to treat MIBC effectively while maintaining natural bladder function.
Purpose of the Study:
- To review and explore the evolving role of radiation therapy techniques in organ preservation for muscle-invasive bladder cancer.
- To discuss the potential of brachytherapy and partial bladder external beam radiation therapy in optimizing treatment for MIBC.
- To highlight advancements in imaging and planning that enable more precise radiation delivery to partial bladder volumes.
Main Methods:
- Review of current literature and established treatment paradigms for muscle-invasive bladder cancer.
- Exploration of partial cystectomy as a treatment option for select MIBC cases.
- Discussion of advanced radiation therapy techniques including adaptive planning and brachytherapy.
Main Results:
- Radiosensitization is a cornerstone of MIBC treatment, demonstrating high local disease control and survival.
- Partial cystectomy shows promise for smaller, solitary tumors, achieving adequate local control and preserving urinary function.
- Modern radiation therapy techniques allow for smaller radiation volumes and more targeted delivery, potentially improving outcomes.
Conclusions:
- Organ preservation for MIBC using trimodality therapy is a viable approach aiming to maintain bladder function.
- Advancements in radiation therapy, including brachytherapy and partial bladder irradiation, offer promising avenues for optimizing MIBC treatment.
- Continued research into precise radiation delivery and adaptive planning is crucial for enhancing the efficacy of organ-sparing strategies in MIBC.
