Efficacy and safety of late-course hypofractionated radiation therapy for muscle-invasive bladder carcinoma after bladder-conserving surgery
| Autor: | Rukun Zang, Zhao Ma, Jinbo Ma, Peng Liu, Ercheng Chen, Lin Wang, Yipeng Song, Jinming Yu |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Chemotherapy Hypofractionated Radiation Therapy Bladder cancer business.industry medicine.medical_treatment Pirarubicin 030232 urology & nephrology General Medicine medicine.disease Acute toxicity Surgery Radiation therapy 03 medical and health sciences 0302 clinical medicine Oncology 030220 oncology & carcinogenesis Carcinoma Medicine Cumulative incidence business medicine.drug |
| Zdroj: | Asia-Pacific Journal of Clinical Oncology. 13:e111-e116 |
| ISSN: | 1743-7555 |
| DOI: | 10.1111/ajco.12351 |
| Popis: | 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 (T2-4N0M0), after transurethral resection, were enrolled. Pirarubicin was given at 30 mg/m2 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. |
| Databáze: | OpenAIRE |
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