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Published in: Supportive Care in Cancer 1/2016

01-01-2016 | Original Article

Hypofractionated palliative radiotherapy for bladder cancer

Authors: Piet Dirix, Sofie Vingerhoedt, Steven Joniau, Ben Van Cleynenbreugel, Karin Haustermans

Published in: Supportive Care in Cancer | Issue 1/2016

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Abstract

Purpose

The aim of this study was to evaluate hematuria-free survival as well as acute and late toxicity after hypofractionated palliative radiotherapy for bladder cancer.

Methods and materials

Between September 2004 and January 2013, 44 patients with biopsy-proven urothelial carcinoma of the bladder were irradiated according to a palliative schedule to a total dose of 34.5 Gy in six fractions of 5.75 Gy given once a week.

Results

After a mean follow-up of 10 months, 91 % of patients were still hematuria free, with a mean hematuria-free survival of 13 months. Severe (≥ grade 3) acute and late urinary toxicity was observed in 9 and 19 % of patients, respectively.

Conclusion

This hypofractionated radiotherapy schedule appears to result in acceptable toxicity and manages successful and long-term palliation of hematuria in most patients.
Literature
1.
go back to reference Ploeg M, Aben KK, Kiemeney LA (2009) The present and future burden of urinary bladder cancer in the world. Worl J Urol 27:289–293CrossRef Ploeg M, Aben KK, Kiemeney LA (2009) The present and future burden of urinary bladder cancer in the world. Worl J Urol 27:289–293CrossRef
2.
3.
go back to reference Freedman ND, Silverman DT, Hollenbeck AR, Schatzkin A, Abnet CC (2011) Association between smoking and risk of bladder cancer among men and women. JAMA 306:737–745PubMedCentralCrossRefPubMed Freedman ND, Silverman DT, Hollenbeck AR, Schatzkin A, Abnet CC (2011) Association between smoking and risk of bladder cancer among men and women. JAMA 306:737–745PubMedCentralCrossRefPubMed
4.
go back to reference Pira E, Piolatto G, Negri E et al (2010) Bladder cancer mortality of workers exposed to aromatic amines: a 58-year follow-up. J Natl Cancer Inst 102:1096–1099CrossRefPubMed Pira E, Piolatto G, Negri E et al (2010) Bladder cancer mortality of workers exposed to aromatic amines: a 58-year follow-up. J Natl Cancer Inst 102:1096–1099CrossRefPubMed
5.
go back to reference Bellmunt J, Orsola A, Wiegel T et al (2011) Bladder cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 22:45–49 Bellmunt J, Orsola A, Wiegel T et al (2011) Bladder cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 22:45–49
6.
go back to reference Advanced bladder cancer meta-analysis collaboration (2003) Neoadjuvant chemotherapy in invasive bladder cancer: a systematic review and meta-analysis. Lancet 361:1927–1934CrossRef Advanced bladder cancer meta-analysis collaboration (2003) Neoadjuvant chemotherapy in invasive bladder cancer: a systematic review and meta-analysis. Lancet 361:1927–1934CrossRef
7.
go back to reference James ND, Hussain SA, Hall E et al (2012) Radiotherapy with or without chemotherapy in muscle-invasive bladder cancer. N Engl J Med 366:1477–1488CrossRefPubMed James ND, Hussain SA, Hall E et al (2012) Radiotherapy with or without chemotherapy in muscle-invasive bladder cancer. N Engl J Med 366:1477–1488CrossRefPubMed
8.
go back to reference Shipley WU, Kaufman DS, Zehr E et al (2002) Selective bladder preservation by combined modality protocol treatment: long-term outcomes of 190 patients with invasive bladder cancer. Urology 60:62–67CrossRefPubMed Shipley WU, Kaufman DS, Zehr E et al (2002) Selective bladder preservation by combined modality protocol treatment: long-term outcomes of 190 patients with invasive bladder cancer. Urology 60:62–67CrossRefPubMed
9.
go back to reference Rödel C, Weiss C, Sauer R (2006) Trimodality treatment and selective organ preservation for bladder cancer. J Clin Oncol 24:5536–5544CrossRefPubMed Rödel C, Weiss C, Sauer R (2006) Trimodality treatment and selective organ preservation for bladder cancer. J Clin Oncol 24:5536–5544CrossRefPubMed
10.
go back to reference Kotwal S, Choudhury A, Johnston C, Paul AB, Whelan P, Kiltie AE (2008) Similar treatment outcomes for radical cystectomy and radical radiotherapy in invasive bladder cancer treated at a United Kingdom specialist treatment center. Int J Radiat Oncol Biol Phys 70:456–463CrossRefPubMed Kotwal S, Choudhury A, Johnston C, Paul AB, Whelan P, Kiltie AE (2008) Similar treatment outcomes for radical cystectomy and radical radiotherapy in invasive bladder cancer treated at a United Kingdom specialist treatment center. Int J Radiat Oncol Biol Phys 70:456–463CrossRefPubMed
11.
go back to reference Abt D, Bywater M, Engeler DS, Schmid H (2013) Therapeutic options for intractable hematuria in advanced bladder cancer. Int J Urol 20:651–660CrossRefPubMed Abt D, Bywater M, Engeler DS, Schmid H (2013) Therapeutic options for intractable hematuria in advanced bladder cancer. Int J Urol 20:651–660CrossRefPubMed
12.
go back to reference Cihoric N, Crowe S, Eychmüller S, Aebersold DM, Ghadjar P (2012) Clinically significant bleeding in incurable cancer patients: effectiveness of hemostatic radiotherapy. Radiat Oncol 7:132PubMedCentralCrossRefPubMed Cihoric N, Crowe S, Eychmüller S, Aebersold DM, Ghadjar P (2012) Clinically significant bleeding in incurable cancer patients: effectiveness of hemostatic radiotherapy. Radiat Oncol 7:132PubMedCentralCrossRefPubMed
13.
go back to reference Wildmark A, Flodgren P, Damber JE, Hellsten S, Cavallin-Ståhl E (2003) A systematic overview of radiation therapy effects in urinary bladder cancer. Acta Oncol 42:567–581CrossRef Wildmark A, Flodgren P, Damber JE, Hellsten S, Cavallin-Ståhl E (2003) A systematic overview of radiation therapy effects in urinary bladder cancer. Acta Oncol 42:567–581CrossRef
14.
go back to reference Maciejewski B, Majewski S (1991) Dose fractionation and tumour repopulation in radiotherapy for bladder cancer. Radiother Oncol 21:163–170CrossRefPubMed Maciejewski B, Majewski S (1991) Dose fractionation and tumour repopulation in radiotherapy for bladder cancer. Radiother Oncol 21:163–170CrossRefPubMed
15.
go back to reference Pos FJ, Hart G, Schneider C, Sminia P (2006) Radical radiotherapy for invasive bladder cancer: what dose and fractionation schedule to choose? Int J Radiat Oncol Biol Phys 64:1168–1173CrossRefPubMed Pos FJ, Hart G, Schneider C, Sminia P (2006) Radical radiotherapy for invasive bladder cancer: what dose and fractionation schedule to choose? Int J Radiat Oncol Biol Phys 64:1168–1173CrossRefPubMed
16.
go back to reference AJCC Cancer Staging Manual, 7th edition, Springer, New York 2010 AJCC Cancer Staging Manual, 7th edition, Springer, New York 2010
17.
go back to reference Rostom AY, Tahir S, Gershuny AR et al (1996) Once weekly irradiation for carcinoma of the bladder. Int J Radiat Oncol Biol Phys 35:289–292CrossRefPubMed Rostom AY, Tahir S, Gershuny AR et al (1996) Once weekly irradiation for carcinoma of the bladder. Int J Radiat Oncol Biol Phys 35:289–292CrossRefPubMed
18.
go back to reference Scholten AN, Leer JWH, Collins CD et al (1997) Hypofractionated radiotherapy for invasive bladder cancer. Radiother Oncol 43:163–169CrossRefPubMed Scholten AN, Leer JWH, Collins CD et al (1997) Hypofractionated radiotherapy for invasive bladder cancer. Radiother Oncol 43:163–169CrossRefPubMed
19.
go back to reference McLaren DB, Morrey D, Mason MD (1997) Hypofractionated radiotherapy for muscle invasive bladder cancer in elderly. Radiother Oncol 43:171–174CrossRefPubMed McLaren DB, Morrey D, Mason MD (1997) Hypofractionated radiotherapy for muscle invasive bladder cancer in elderly. Radiother Oncol 43:171–174CrossRefPubMed
20.
go back to reference Jose CC, Price A, Norman A et al (1999) Hypofractionated radiotherapy for patients with carcinoma of the bladder. Clin Oncol 11:330–333CrossRef Jose CC, Price A, Norman A et al (1999) Hypofractionated radiotherapy for patients with carcinoma of the bladder. Clin Oncol 11:330–333CrossRef
21.
go back to reference Pos FJ, van Tienhoven G, Hulshof M et al (2003) Concomitant boost radiotherapy for muscle invasive bladder cancer. Radiother Oncol 68:75–80CrossRefPubMed Pos FJ, van Tienhoven G, Hulshof M et al (2003) Concomitant boost radiotherapy for muscle invasive bladder cancer. Radiother Oncol 68:75–80CrossRefPubMed
22.
go back to reference Kouloulias V, Tolia M, Kolliarakis N et al (2013) Evaluation of acute toxicity and symptoms palliation in a hypofractionated weekly schedule of external radiotherapy for elderly patients with muscular invasive bladder cancer. Int Braz J Urol 39:77–82CrossRefPubMed Kouloulias V, Tolia M, Kolliarakis N et al (2013) Evaluation of acute toxicity and symptoms palliation in a hypofractionated weekly schedule of external radiotherapy for elderly patients with muscular invasive bladder cancer. Int Braz J Urol 39:77–82CrossRefPubMed
23.
go back to reference Lutz S, Berk L, Chang E et al (2011) Palliative radiotherapy for bone metastases: an ASTRO evidence-based guideline. Int J Radiat Oncol Biol Phys 79:965–976CrossRefPubMed Lutz S, Berk L, Chang E et al (2011) Palliative radiotherapy for bone metastases: an ASTRO evidence-based guideline. Int J Radiat Oncol Biol Phys 79:965–976CrossRefPubMed
Metadata
Title
Hypofractionated palliative radiotherapy for bladder cancer
Authors
Piet Dirix
Sofie Vingerhoedt
Steven Joniau
Ben Van Cleynenbreugel
Karin Haustermans
Publication date
01-01-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 1/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-015-2765-y

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