Long-term results of a concomitant boost radiotherapy technique for elderly patients with muscle-ınvasive bladder cancer. Issue 4 (July 2015)

• Record Type: Journal Article
• Authors: Canyilmaz, Emine; Yoney, Adnan; Serdar, Lasif; Uslu, Gonca Hanedan; Aynaci, Ozlem; Haciislamoglu, Emel; Bahat, Zumrut; Yavuz, Melek Nur
• Is Part Of: Journal of geriatric oncology. Volume 6:Issue 4(2015)
• Page Start: 316
• Page End: 323
• Publication Date: 2015-07
• Subjects: Geriatric oncology -- Periodicals; Neoplasms -- Periodicals; Aged -- Periodicals; Geriatric oncology; Electronic journals; Periodicals; 618.976994005
• DOI: 10.1016/j.jgo.2015.04.004
• Languages: English
• ISSNs: 1879-4068

Abstract

<abstract abstract-type="author" id="ab0005"> <title id="st0005">Abstract</title> <sec> <title id="st0010">Objectives</title> <p id="sp0005">To evaluate the long-term clinical efficacy and toxicity of concomitant boost radiotherapy (CBRT) in elderly patients with invasive bladder cancer.</p> </sec> <sec> <title id="st0015">Methods and Materials</title> <p id="sp0010">Elderly patients (n = 188; mean 75-year-old, range 70–91 years; 88.3% male/11.7% female) with T1–T4a bladder carcinoma were irradiated with CBRT. A total of 24 (12.8%) patients were diagnosed at stage T1, 117 (62.2%) were at stage T2, 28 (14.9%) at were stage T3a, 14 (7.4%) were stage T3b, and 5 (2.7%) were stage T4a. A dose of 45 Gy in 1.8 Gy fractions was administered to the whole pelvis 5 days/week over 5 weeks. A concomitant boost limited to the bladder tumor area plus margin or whole bladder of 22.5 Gy in 1.5 Gy fractions was administered from weeks 3 × 5. Thus, irradiaiton totalled 67.5 Gy over 5 weeks. The interfraction interval was ≥ 6 h/treatment day. We assessed prognostic factors for overall survival (OS), cause-specific survival (CSS) and relapse-free survival (RFS).</p> </sec> <sec> <title id="st0020">Results</title> <p id="sp0015">Median follow-up was 46.2 months (range 4.7–155.7 months). Median overall survival was 27 months (95% CI:21–33 months). In this study, 146 (77.7%) patients had complete response, 39 (20.7%) had residual disease and 4 (1.6%) had progressive disease. The mean 3-, 5- and 10-year OS rates were respectively 41.2% (S.E. ± 0.036), 29% (S.E. ± 0.034), and 13.8% (S.E. ± 0.031). Significant prognostic factors for OS and CSS, by multivariate analysis, were tumor T-stage and urothelial obstruction.</p> </sec> <sec> <title id="st0025">Conclusion</title> <p id="sp0020">This CBRT protocol provided excellent results with a high complete response rate and good tolerance. This approach may therefore be particularly appropriate for elderly patients with invasive bladder cancer.</p> </sec> </abstract>