338330

Whole Pelvis versus Bladder Only Radiotherapy in Trimodality Therapy for Negative Lymph Node Muscle Invasive Bladder Cancer

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Last updated: 03 Jan 2025

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Abstract

Background: Trimodality therapy has been recommended as a valid treatment option for well-selected patients of muscle invasive bladder cancer (MIBC). The benefit of elective nodal irradiation during bladder radiotherapy (RT) remains a controversial topic. Objectives: Our study comparing bladder only (BO) versus whole pelvis (WP) radiotherapy, concurrent with cisplatin to evaluate BO radiotherapy outcome and toxicity. Patients and methods: A randomized prospective study comparing BO versus WP radiotherapy using 3D conformal radiotherapy concurrent with cisplatin followed by 4 cycles gemcitabine/cisplatin in nonmetastatic negative lymph node MIBC. Results: Our cohortincluded 28 and 30 patients in BO and WP group, respectively. No statistically significant difference (P =0.59) was detected between 2 groups as regard disease free survival (DFS)rate at 3 years, which was 81% and 85 % in BO and WP group, respectively. At 3 years the reported bladder cancer specific survival and  overall survival(OS) rate in BO group was 83% and 75 %, respectively while for WP group the results were 80 % and 73%, respectively with no statistically significant difference between the 2 groups. Regarding RT toxicity, acute small bowel (P=0.03) and acute rectal toxicity (P=0.007) showed statistically significant difference favouring BO radiotherapy while acute genitourinary toxicity (P=0.91), late genitourinary (P =0.33) and late GIT toxicity (P=0.4) showed no statistically significant difference between the 2 groups. Conclusion: BO radiotherapy concurrent with chemotherapy is an effective treatment option in patients with lymph node-negative MIBC with comparable oncologic outcomes and less RT toxicity when compared with WP radiotherapy.

DOI

10.21608/ejhm.2024.338330

Volume

94

Article Issue

1

Related Issue

45268

Issue Date

2024-01-01

Receive Date

2024-01-25

Publish Date

2024-01-01

Page Start

427

Page End

435

Print ISSN

1687-2002

Online ISSN

2090-7125

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https://ejhm.journals.ekb.eg/article_338330.html

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https://ejhm.journals.ekb.eg/service?article_code=338330

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63

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Whole Pelvis versus Bladder Only Radiotherapy in Trimodality Therapy for Negative Lymph Node Muscle Invasive Bladder Cancer

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Article

Created At

24 Dec 2024