Hypofractionation versus conventional radiotherapy with concurrent Gemcitabine in bladder preservation of patient with bladder carcinoma | ||||
SECI Oncology Journal | ||||
Article 1, Volume 4, Issue 2, April 2016, Page 21-27 PDF (242.35 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/secioj.2016.5679 | ||||
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Abstract | ||||
Background: This prospective, phase III study aimed at evaluation the efficacy and toxicity of hypofractionated radiation schedule versus conventional radiation given concurrent with weekly Gemcitabine. Patient and methods: Fifty one patients with transitional cell carcinoma, stage T1-4a, N0, M0 after transurethral resection [TUR] and magnetic resonance imaging, were recruited. Patients were categorized into two groups: 33 patients [in Group A] who were treated with hypofractionated radiotherapy [RT] schedule that delivered 52.5 Gy in 20 fractions and 18 patients [in Group B] who were treated with conventional RT schedule 64 Gy in 32 fractions. Both groups received weekly Gemcitabine 100mg/m². Results: the majority of patients achieved complete response (CR); in group A (81.8%) and in group B (66.7%). There were significant difference between the two study groups regarding 2 year overall survival [OS] rate (88.2% vs 75.6% in group A& B respectively, P= 0.049) and relapse free survival [RFS] (66.6% vs 56.7% in group A& B respectively with P =0.033) in favor of group A. There were significant difference between the two study groups, in favor of group A, regarding cystitis (P= 0.038) and enteritis (P ˂0.001). Conclusion: The hypofractionated radiation proved to be of higher CR rate and survival rate with the favorable toxicity profile than that of conventionally fractionated radiation schedule given concurrently with Gemcitabine. | ||||
Keywords | ||||
Altered fractionation; Bladder cancer; Radiotherapy; Survival | ||||
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