Bladder preservation with conformal radiotherapy using a simultaneous boost with concurrent cisplatin in patients with muscle-invasive bladder cancer | ||||
| SECI Oncology Journal | ||||
| Volume 10, Issue 2, May 2022, Page 129-135 | ||||
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| Abstract | ||||
| Background: The estimated annual incidence of bladder cancer in Egypt is 10,655 cases, accounting for 7.9% of all newly diagnosed cancers. Sharkia population exceeds 8 million with only a few radiotherapy machines available, in addition, the global coronavirus (COVID-19) pandemic, therefore, shorter overall treatment duration would be more convenient for the patient quality of life. Purpose: The aim of this study is to evaluate treatment outcome of bladder preservation with conformal radiotherapy using a simultaneous boost with concurrent cisplatin in patients with muscle-invasive bladder cancer (MIBC). Materials and methods: From May 2021 to April 2022, 34 patients with muscle-invasive transitional cell bladder cancer, T2–3 N0 M0 were treated with maximum transurethral resection of bladder tumor (TURBT), followed by conformal hypofractionated radiotherapy in a dose of 2.4 Gy to the pelvis in the morning and a simultaneous radiotherapy boost in the evening in a dose of 1.33 Gy to the whole bladder for all 15 days of treatment (36 Gy to the pelvis and 20 Gy to whole bladder) with a weekly Cisplatin dose of 30 mg/m2 . Treatment outcome was assessed by response and toxicity. Results: All 34 patients with a median age of 57 ± 6.64 years completed their treatment regimen. After 3 months of therapy, 26 patients (76.5%) had an overall response, whereas 8 patients (23.5%) showed no response. Grade 3 anemia was prominent in 3 patients (8.8%), whereas, acute grade 3 cystitis persisted in 5 patients (14.7%). There were no reports of life-threatening complications or grade 4 toxicity. Conclusions: Conformal radiotherapy using a simultaneous boost with concurrent cisplatin in patients with muscle-invasive bladder cancer is a shortened and acceptable alternative to the prolonged 6-6.5 weeks radiotherapy protocol in T2–3 N0 M0 bladder cancer. Absence of hydronephrosis and complete TUR are of better outcome. Recommendation: Other radiosensitizers can be experimented and enrollment of larger number of patients can be of better significance. In addition, new protocols using node-positive disease could be further studied over extended periods with documentation of local control and survival. | ||||
| Keywords | ||||
| Bladder preservation; simultaneous boost; cisplatin | ||||
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