EFFICIENCY OF BEAM RADIOTHERAPY FOR NON-MUSCLE-INVASIVE BLADDER CANCER

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Abstract

Objective: to evaluate the efficiency of beam radiotherapy (BRT) in patients with non-muscle-invasive bladder cancer (NMIBC).

Subjects and methods. The data on 40 patients diagnosed as having stage T1 NMIBC, who had been treated at the Medical Radiology Center in 1990 to 2009, were studied. Of them, 75% were aged < 70 years. They all had verified transitional cell carcinoma: G1 in 11 (27.5%) patients; G2 in 12 (30%), and G3 in 17 (42.5%). Multifocal tumor growth (T1m) was found in 22 (55%); the largest tumor exceeded 3 cm in 31 (77.5%). More than half (60%) of the patients had clinically significant concomitant diseases. Three (7.5%) had a history of treated malignancy. The mean follow-up of the patients was 58.6 months.

Results. Survival at 60 months follow-up was 67.9 ± 8.0%. Three (7.5 %) patients died at 21–42 months follow-up. Five-year relapse-free survival was 50.0 ± 8.5%. Seven (17.5 %) patients were withdrawn at 5 to 99 months follow-up (mean 34.7 months). Four (10 %) patients died from disease progression at 21 to 143 months follow-up. After radiotherapy to the bladder area, 17 (42.5 %) patients were diagnosed as having more than 50 % tumor regression, which permitted transurethral resection of a residual tumor. The frequency and degree of radiation reactions were estimated. Acute radiation cystitis was diagnosed in 11 (27.5 %) patients and rectitis was found in 6 (15.0 %). Radiation reactions were not a reason for forced treatment discontinuation. Grade I-II late radiation cystitis (RTOG/EORTC) was diagnosed in 9 (22.5 %) patients.

Conclusion. The efficiency of BRT in patients with NMIBC who had refused surgical treatment or had contraindications to it was confirmed during the study. BRT could preserve the functioning bladder in 97.5 % of cases and remove the residual tumor in 42.5 %. Radiation reactions were not a reason for forced treatment interruption.

About the authors

K. N. Safiullin

Medical Radiology Research Center, Ministry of Health and Social Development of Russia, Obninsk

Author for correspondence.
Email: safiulin@mrrc.obninsk.ru
Russian Federation

Yu. V. Gumenetskaya

Medical Radiology Research Center, Ministry of Health and Social Development of Russia, Obninsk

Email: safiulin@mrrc.obninsk.ru
Russian Federation

O. B. Karyakin

Medical Radiology Research Center, Ministry of Health and Social Development of Russia, Obninsk

Email: safiulin@mrrc.obninsk.ru
Russian Federation

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