Role of Radiotherapy with or without Chemotherapy in Treatment of Cancer Urinary Bladder Surgically Excised: A Retrospective Study | ||||
| SECI Oncology Journal | ||||
| Volume 11, Issue 4, October 2023, Page 314-324 | ||||
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| Abstract | ||||
| Background: BC is the 10th most common cancer type worldwide. About 75% of BC is non muscle invasive (NMIBC). However, in MIBC, the standard therapeutic approach consists of neoadjuvant chemotherapy, radical cystectomy (RC), +/- adjuvant chemotherapy. Following RC, in patients with ≥pT3 disease, loco regional recurrence is a significant problem. Adding RTH to CTH in this situation has demonstrated a significant reduction in the rate of loco regional failure. Purpose of the study: In this retrospective study, we aim to investigate the outcome of treatment of MIBC by RC and post operative RTH +/- CTH. Patients and methods: This is a retrospective study included patients treated in Sohag University by RC with urinary diversion and pelvic RTH+/- CTH from January 2016 through December 2020. Results: A cohort of 75 patients identified, Males constituted 91% of them. Two subgroups were identified, tcc and scc representing 69% and 28% respectively. Chemotherapy was documented in 61% of patients. Conventional 2 D RTH technique was implemented in 31 (41%) patients and 3 D RTH technique in 44 (59%) patients. Local, nodal and, distant failures were identified in 9 (12%), 6 (8%) and 7 (9%) patients respectively. Owing to the small number of distinct types of failures and for more meaningful statistical results, all failures were allocated in one group. Only T stage was found significantly affecting the OS in the whole cohort (p=0.05) but not in either one of the two subgroups, TCC and SCC. Both coexistent hypertension and DM significantly reduced the PFS in the whole cohort (p = 0.007 and 0.003 respectively) and in the TCC subgroup only (p = 0.041 and 0.011 respectively). Adding CTH to RTH significantly improved the OS in the TCC subgroup (p = 0.05). Conclusions: In treatment of MIBC by RC, RTH and CTH, advanced stage, lack of cisplatin based CTH, co existent hypertension and DM adversely affect treatment outcome and further observational studies warranted to elucidate the influence of these comorbidities on treatment outcome. | ||||
| Keywords | ||||
| Muscle invasive bladder cancer; radical cystectomy; post operative radiotherapy; chemotherapy | ||||
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