Radiotherapy in the patients with bladder carcinoma treated by conservative surgery
- VernacularTitle:膀胱癌患者保留膀胱术后的放射治疗
- Author:
Yunhai LI
;
Yan FENG
- Publication Type:Journal Article
- Keywords:
bladder neoplasms/surgery;
bladder neoplasms/radiotherapy;
prognosis
- From:China Oncology
2000;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Background and purpose:Radical cystectomy is viewed as the standard treatment for bladder carcinoma,but organ preservation has been attempted for patients with muscle-invasive bladder carcinoma over the past decades as an alternative to radical cystectomy.The majority of studies included transurethral resection of bladder tumor(TURB),radiotherapy,and chemotherapy,as a feasible and safe organ-sparing approach with the similar outcome to radical cystectomy.The current study evaluated the outcomes and complications of the radiation therapy for the patients with bladder cancer,and prognosis factors had been analyzed.Methods:We retrospectively analyzed 21 patients with bladder cancer.The clinical stages of the patients were 15 with T_2;5 with T_3 and 2 with T_4.2 of them were lymph node-positive,16 of patients were pathologically proved as transitional cell carcinoma,4 as adenocarcinoma and 1 as transitional cell carcinoma plus squamous cell carcinoma.Conventional fractionation radiotherapy was given at a median dose of 54.5Gy(ranged 49.2-69.9 Gy) after surgery.Kaplan-Meier method and Logrank method were used for the statistical analysis.Results:Median follow-up was 32 months.The overall survivals at 1 year,3 years and 5 years were 90.5%,47.1%,and 36.7% respectively.The local disease free rates were 95.0%,62.4%,and 47.5% respectively.15 of 16 patients' deaths were related to the tumor.In univariate analysis,only small field irradiation was found as a prognosis factor in survival(?~(2)=5.36,P=0.02).Conclusions:Combined treatment appears to provide high response rates and can be offered as an alternative option to radical cystectomy for selected patients who refuse or are unsuitable for surgery.A large number of patients,multicenter,prospective randomized trial would be desirable to evaluate the role of radiotherapy in the multi-modality treatment of bladder cancer.
