Bladder Only Radiotherapy Concurrent with Chemotherapy Outcomes in Muscle Invasive Bladder Cancer Management: Our Institute Experience

Abstract

Background: Bladder only radiotherapy (RT) concurrent with chemotherapy emerged as a valid treatment option for patients with  muscle invasive bladder cancer (MIIBC) with complete response to chemoradiotherapy, has been associated with better survival  outcomes.

Objectives: Our study evaluates bladder only RT outcomes as regard locoregional and distant metastasis in negative lymph node MIBC and evaluates associations between patients, tumor characteristics, and treatment and complete response to chemoradiotherapy.

Patients and methods: This prospective study was conducted in Sohag University Hospital and Sohag Cancer  Institute. This study was a part of study comparing bladder only RT versus whole pelvis RT. The study included 28 patients diagnosed as  nonmetastatic negative lymph node MIBC. Patients underwent maximum transurethral resection of bladder tumor (TURBT) then received  bladder only RT, concurrent with cisplatin then 4 cycles gemcitabine/cisplatin.

Results: Complete response was achieved in 75%  of patients on cystoscopy assessment at 3 months post chemoradiotherapy. With median follow up of 3 years, locoregional recurrence  free survival rate and distant metastasis free survival rate at 3 years were 85 % and 82 %, respectively. Complete TURBT, absence of  carcinoma in situ (CIS) and concurrent chemotherapy were related to achieving complete response following bladder only RT concurrent  with cisplatin but with no statistical significance, maybe due to small sample size.

Conclusion: Bladder only radiotherapy is an effective  treatment option as a part of trimodality therapy for negative lymph node MIBC with complete TURBT, absence of CIS and concurrent  chemotherapy is associated with complete response.