A practical approach to bladder preservation with hypofractionated radiotherapy for localised muscle-invasive bladder cancer
Authors
Portner, RobinBajaj, A.
Elumalai, Thiraviyam
Huddart, R.
Murthy, V.
Nightingale, Hannah
Patel, Kamlesh
Sargos, P.
Song, Yee Pei
Hoskin, Peter J
Choudhury, Ananya
Affiliation
The Christie NHS Foundation Trust, Manchester, UKIssue Date
2021
Metadata
Show full item recordAbstract
Bladder preservation with trimodality treatment (TMT) is an alternative strategy to radical cystectomy (RC) for the management of localised muscle invasive bladder cancer (MIBC). TMT comprises of transurethral resection of the bladder tumour (TURBT) followed by radiotherapy with concurrent radiosensitisation. TMT studies have shown neo-adjuvant chemotherapy with cisplatin-based regimens is often given to further improve survival outcomes. A hypofractionated radiotherapy regimen is preferable due to its non-inferiority in local control and late toxicities. Radiosensitisation can comprise concurrent chemotherapy (with gemcitabine, cisplatin or combination fluorouracil and mitomycin), CON (carbogen and nicotinomide) or hyperthermic treatment. Radiotherapy techniques are continuously improving and becoming more personalised. As the bladder is a mobile structure subject to volumetric changes from filling, an adaptive approach can optimise bladder coverage and reduce dose to normal tissue. Adaptive radiotherapy (ART) is an evolving field that aims to overcome this. Improved knowledge of tumour biology and advances in imaging techniques aims to further optimise and personalise treatment.Citation
Portner R, Bajaj A, Elumalai T, Huddart R, Murthy V, Nightingale H, et al. A practical approach to bladder preservation with hypofractionated radiotherapy for localised muscle-invasive bladder cancer. Clinical and Translational Radiation Oncology. 2021 Nov;31:1–7.Journal
Clinical and Translational Radiation OncologyDOI
10.1016/j.ctro.2021.08.003PubMed ID
34466667Additional Links
https://dx.doi.org/10.1016/j.ctro.2021.08.003Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1016/j.ctro.2021.08.003
Scopus Count
Collections
Related articles
- Radical cystectomy versus organ-sparing trimodality treatment in muscle-invasive bladder cancer: A systematic review of clinical trials.
- Authors: Arcangeli G, Strigari L, Arcangeli S
- Issue date: 2015 Sep
- Critical analysis of bladder sparing with trimodal therapy in muscle-invasive bladder cancer: a systematic review.
- Authors: Ploussard G, Daneshmand S, Efstathiou JA, Herr HW, James ND, Rödel CM, Shariat SF, Shipley WU, Sternberg CN, Thalmann GN, Kassouf W
- Issue date: 2014 Jul
- Comparison of outcomes between trimodal therapy and radical cystectomy in muscle-invasive bladder cancer: a propensity score matching analysis.
- Authors: Kim YJ, Byun SJ, Ahn H, Kim CS, Hong BS, Yoo S, Lee JL, Kim YS
- Issue date: 2017 Sep 15
- Transurethral Resection of Bladder Tumor (TUR-BT) then Concomitant Radiation and Cisplatin Followed by Adjuvant Gemcitabine and Cisplatin in Muscle Invasive Transitional Cell Carcinoma (TCC) of the Urinary Bladder.
- Authors: Ibrahim SM, Abd El-Hafeez ZM, Mohamed EM, Elsharawy IA, Kamal KM
- Issue date: 2007 Mar
- Patterns of Bladder Preservation Therapy Utilization for Muscle-Invasive Bladder Cancer.
- Authors: Rose TL, Deal AM, Ladoire S, Créhange G, Galsky MD, Rosenberg JE, Bellmunt J, Wimalasingham A, Wong YN, Harshman LC, Chowdhury S, Niegisch G, Liontos M, Yu EY, Pal SK, Chen RC, Wang AZ, Nielsen ME, Smith AB, Milowsky MI, Retrospective International Study of Cancers of the Urothelial Tract (RISC) Investigators
- Issue date: 2016 Oct 27