Premium
Efficacy and safety of late‐course hypofractionated radiation therapy for muscle‐invasive bladder carcinoma after bladder‐conserving surgery
Author(s) -
Song Yipeng,
Ma Jinbo,
Wang Lin,
Chen Ercheng,
Liu Peng,
Ma Zhao,
Zang Rukun,
Yu Jinming
Publication year - 2017
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12351
Subject(s) - pirarubicin , medicine , radiation therapy , urology , surgery , survival rate , cumulative incidence , toxicity , carcinoma , chemotherapy , transplantation
Aim To evaluate the efficacy and safety of late‐course hypofractionated radiation treatment of muscle‐invasive bladder carcinoma after bladder‐conserving surgery. Methods Seventy‐six patients with transitional cell bladder carcinoma, stage II ( T 2‐4 N 0 M 0), after transurethral resection, were enrolled. Pirarubicin was given at 30 mg/m 2 and 100 mL physiological saline once weekly ( QW ) for 12 weeks through and after intravesical instillation postoperatively. Radiation schedule delivered 46 Gy in 20 fractions for planning target volume, with an additional 20 Gy in five fractions for gross tumor volume as late‐course radiation. Chemotherapy was stopped if Radiation Therapy Oncology Group grade 3 or higher bladder or bowel toxicity occurred. The primary end points were acute toxicity, local control and patients' survival. Results One‐, three‐ and five‐year overall survival rates were 98, 78 and 69.5%, respectively. Mean survival time was 58.4 months (95% CI : 52.6, 64.2). In addition, 1‐, 3‐ and 5‐year local control rates were 100, 80.5 and 76.1%, respectively. Mean local control time was 60.7 months (95% CI : 55.1, 66.3). The cumulative incidence of local/regional failure and distant failure was 28.9%. The rate of single local/regional failure was 13.2%, but distant failure rate was 21.1%. Conclusions Concurrent pirarubicin‐based late‐course hypofractionated radiation therapy showed desirable local control rate and acceptable toxicity. It could be used after bladder‐conserving surgery to allow patients to preserve their bladder.