Hypofractionated radiation therapy (Hypo-RT) for the treatment of localized bladder cancer Journal Article
| Authors: | Moore, A.; Lobaugh, S. M.; Zhang, Z.; Rosenberg, J. E.; Iyer, G.; Teo, M. Y.; Bochner, B.; Donahue, T.; Nunez, D. A.; Dreyfuss, A.; Gorovets, D.; Zelefsky, M. J.; Kollmeier, M. A. |
| Article Title: | Hypofractionated radiation therapy (Hypo-RT) for the treatment of localized bladder cancer |
| Abstract: | BACKGROUND: Various radiotherapeutic regimens are used in the treatment of bladder cancer. OBJECTIVE: We aimed to evaluate early toxicity and outcomes associated with hypofractionated radiation therapy (Hypo-RT), 55Gy in 20 fractions. MATERIAL AND METHODS: We identified 40 patients who received definitive Hypo-RT for localized bladder cancer. Most patients were men (62.5%), elderly (median age 82), had high Charlson Comorbidity Index score (median 7, range 4-9) and were nonsurgical candidates (80%). Sixty-eight percent had a macroscopically complete transurethral resection of bladder tumor (TURBT) and 33 patients (82.5%) received concurrent chemotherapy. Acute (< =3mo) and late (>3mo) toxicities were assessed according to CTCAE v4.0. Survival outcomes were estimated using the Kaplan-Meier method. Median follow up after Hypo-RT was 32 months (95% CI: 28-49 months). RESULTS: Overall rates of acute grade 2 genitourinary (GU) and gastrointestinal (GI) toxicities were 40% each, most commonly urinary frequency and diarrhea. Two cases of acute grade 3 GU/GI toxicity occurred. Late grade 2+ toxicity occurred in 3 patients (7.5%): 2 grade 2 GU and 1 grade 3 GI. Seventy-seven percent achieved a complete response (CR). Six patients (20%) developed disease recurrence at a median time of 9.1 months. The estimated 2-year DFS and 2-year DSS rate were 59% (95% CI, 45-78%) and 78% (95% CI, 65-93%), respectively. Receipt of concurrent chemotherapy (p = 0.003) and achieving a CR (p = 0.018) were univariably associated with improved DSS. Tis component was associated with worse DSS (p = 0.015). CONCLUSION: Hypo-RT had a favorable toxicity profile and encouraging cancer control outcomes in this mostly elderly and frail patient cohort. © 2023 - The authors. |
| Keywords: | radiotherapy; bladder cancer; toxicity; bladder preservation |
| Journal Title: | Bladder Cancer |
| Volume: | 9 |
| Issue: | 2 |
| ISSN: | 2352-3727 |
| Publisher: | IOS Press |
| Date Published: | 2023-01-01 |
| Start Page: | 141 |
| End Page: | 150 |
| Language: | English |
| DOI: | 10.3233/blc-220121 |
| PROVIDER: | scopus |
| PMCID: | PMC11181850 |
| PUBMED: | 38993294 |
| DOI/URL: | |
| Notes: | Article -- MSK corresponding author is Marisa Kollmeier -- Source: Scopus |
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