Trimodality Therapy in which Concurrent Chemoradiation with Concomitant Boost in Muscle Invasive TCC Urinary Bladder
Ayatallah Ali Youssief Mohammed1, Doaa Ali Gamal2, Ahmed Refaat Abd Elzaher3
1Lecturer of Radiotherapy and Nuclear Medicine, South Egypt Cancer Institute, Assiut University, Egypt.
Asian Pacific Journal of Cancer Prevention : APJCP
|February 28, 2023
Summary
External-beam irradiation with a concomitant boost offers a safe and effective bladder-sparing treatment for muscle-invasive bladder cancer, demonstrating high survival rates and acceptable toxicity. This approach shows promising results for patients unsuitable for surgery.
Area of Science:
- Oncology
- Radiation Oncology
- Urogynecology
Background:
- Bladder cancer is a prevalent genitourinary malignancy, particularly in Egyptian males.
- Bladder-sparing therapy presents a viable alternative for patients who decline or cannot undergo surgery.
- External-beam irradiation with a concomitant boost is explored as a conservative treatment option.
Purpose of the Study:
- To assess the safety and feasibility of external-beam irradiation with a concomitant boost for muscle-invasive bladder cancer.
- To determine the short-term (1-year) risk of bladder cancer recurrence following this treatment.
Main Methods:
- A prospective, one-arm trial involving 42 patients with pathologically confirmed muscle-invasive bladder cancer (cT2-4aN0M0).
- Patients received maximal transurethral resection of bladder tumor (TURBT) followed by chemoradiation therapy (45 Gy/25 fractions) with concurrent cisplatin.
- A concomitant boost to 60 Gy was delivered to the bladder plus a 1.5 cm margin during the final 10 days of the 5-week treatment.
Main Results:
- The median overall survival was 28 months, with a 1-year OS of 100%.
- One-year loco-regional relapse-free survival (LRRFS) was 92.9%, with a 2-year LRRFS of 66.7%.
- Acute and late genitourinary toxicity was predominantly Grade 2, while gastrointestinal toxicity was Grade 1 or less.
Conclusions:
- External radiotherapy utilizing a concomitant boost technique in muscle-invasive bladder cancer offers a high likelihood of local control and overall survival.
- Shortening the overall treatment time with this method yields favorable outcomes.
- The treatment demonstrates acceptable toxicity profiles, supporting its use as a bladder-sparing option.
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