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Postoperative radiation therapy for muscle-invading bladder carcinoma.
Journal of Surgical Oncology
|August 1, 1983
Summary
Adjuvant postoperative radiation therapy (XRT) for advanced bladder cancer showed a 54% two-year survival rate. Improved radiation techniques are needed to enhance regional control and reduce complications in bladder carcinoma patients.
Area of Science:
- Oncology
- Radiation Oncology
- Surgical Oncology
Background:
- Bladder carcinoma poses significant treatment challenges, particularly for advanced stages (pT2-4).
- Adjuvant postoperative radiation therapy (XRT) is a potential multimodality approach for high-risk bladder cancer patients.
Purpose of the Study:
- To evaluate the efficacy and complications of adjuvant postoperative XRT in patients with pT2-4 bladder carcinoma.
Main Methods:
- Retrospective analysis of 15 patients with pT2-4 bladder carcinoma treated with adjuvant postoperative XRT (4,000-5,040 rads) between 1974-1980.
- Initial surgery varied, including radical cystectomy, partial cystectomy, and transurethral resection.
- Pelvic XRT was followed by a bladder boost in non-cystectomized patients.
Main Results:
- Two-year and five-year survival rates were 54% and 27%, respectively.
- Local-regional disease control was achieved in 63% of patients with a minimum two-year follow-up.
- Two of seven patients alive at two years experienced small bowel complications, both having undergone radical cystectomy.
Conclusions:
- Adjuvant postoperative XRT may benefit selected high-risk bladder carcinoma patients.
- Current radiation techniques require improvement to enhance regional control and minimize complications, especially in patients who have had radical cystectomy.