Discouraging results for high dose external beam radiation therapy in low stage (O and A) bladder cancer

Eight patients who received high dose external beam radiation therapy for low stage (O and A) bladder cancer with curative intent subsequently presented with recurrent tumors or complications of radiotherapy that led to cystectomy. The dismal results of high dose radiotherapy in these patients prompted us to review the published results for so-called definitive radiation therapy in patients with low stage bladder cancer. From this review and our own patients we conclude that high dose external beam radiotherapy is less than optimal treatment for patients with low stage bladder cancer. This is true even for the subset of patients with tumor characteristics that place them at high risk for the subsequent development of invasive disease.