The efficacy of radiotherapy for muscle invasive bladder cancer and its associated factors analysis
Junjun Gao, Yueping Liu, Jianzhong Shou, Yexiong Li, Jing Jin, Hui Fang, Shulian Wang, Yongwen Song, Bo Chen, Shunan Qi, Yuan Tang, Yu Tang, Ning Li, Ningning Lu, Zihao Yu
Abstract
ObjectiveTo analyze the efficacy and its impacting factors of pelvic confined muscle invasive bladder cancer (MIBC) treated with radiotherapy, also including the preservation of functional bladders and the treatment related late toxicity.
MethodsForty-five MIBC patients who received radiotherapy from March 1999 to October 2016 in our hospital were analyzed.41 of the patients were transitional cell carcinomas. The radiation volume included the bladder±pelvic lymph node with or without local tumor boost, with a median bladder dose of 45 Gy and median tumor dose of 56 Gy.24 patients received concurrent chemoradiotherapy.14 patients received neoadjuvant chemotherapy, and 29 underwent transurethral resection of bladder tumors before radiotherapy.
ResultsThe median follow-up duration was 28 months (range, 4–101 months). The 3-year overall survival were 51%.Concurrent chemoradiotherapy had a better survival than that of radiation alone, with 3-year overall survival of 64% and 30%(P=0.001). The effect of neoadjuvant chemotherapy on 3-year overall survival was not obvious, 59% and 47%(P=0.540) with or without neoadjuvant chemotherapy. The 3-year overall survival were 58% and 43%(P=0.160), respectively for patients with or without the transurethral resection of bladder tumors. The 3-year overall survival were 20% and 79%(P=0.001) for patients with or without relapse. Nine patients recurred locally and fourteen patients developed metastases. The highest bowel toxicity of more than 3 months after radiotherapy was grade 2 in 2 patients. Late grade 2 urinary toxicity occurred in 4 patients, grade 3 in 2 patients. All other patients preserved their functional bladders except 7 patients who had an uncontrolled bladder tumors or radiation induced severe injury of bladder function.
ConclusionsA better survival could be obtained for localized muscle invasive bladder cancer treated with concurrent chemoradiotherapy. Most of the patients can preserve their functional bladders after radiotherapy, and the late toxicity is acceptable.
Key words:
Bladder neoplasms/chemoradiotherapy; Treatment outcome
Contributor Information
Junjun Gao
Department of Radiation Oncology, Cancer Hospital and Institute, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing
Yueping Liu
Department of Radiation Oncology, Cancer Hospital and Institute, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing
Jianzhong Shou
Department of Urology, Cancer Hospital and Institute, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing
Yexiong Li
Department of Radiation Oncology, Cancer Hospital and Institute, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing
Jing Jin
Department of Radiation Oncology, Cancer Hospital and Institute, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing
Hui Fang
Department of Radiation Oncology, Cancer Hospital and Institute, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing
Shulian Wang
Department of Radiation Oncology, Cancer Hospital and Institute, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing
Yongwen Song
Department of Radiation Oncology, Cancer Hospital and Institute, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing
Bo Chen
Department of Radiation Oncology, Cancer Hospital and Institute, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing
Shunan Qi
Department of Radiation Oncology, Cancer Hospital and Institute, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing
Yuan Tang
Department of Radiation Oncology, Cancer Hospital and Institute, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing
Yu Tang
Department of Radiation Oncology, Cancer Hospital and Institute, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing
Ning Li
Department of Radiation Oncology, Cancer Hospital and Institute, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing
Ningning Lu
Department of Radiation Oncology, Cancer Hospital and Institute, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing
Zihao Yu
Department of Radiation Oncology, Cancer Hospital and Institute, National Cancer Center/National Clinical Research Center for Cancer, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing
