Long-term results of a concomitant boost radiotherapy technique for elderly patients with muscle-ınvasive bladder cancer
Copyright © 2015 Elsevier Inc. All rights reserved..
OBJECTIVES: To evaluate the long-term clinical efficacy and toxicity of concomitant boost radiotherapy (CBRT) in elderly patients with invasive bladder cancer.
METHODS AND MATERIALS: Elderly patients (n=188; mean 75-year-old, range 70-91 years; 88.3% male/11.7% female) with T1-T4a bladder carcinoma were irradiated with CBRT. A total of 24 (12.8%) patients were diagnosed at stage T1, 117 (62.2%) were at stage T2, 28 (14.9%) at were stage T3a, 14 (7.4%) were stage T3b, and 5 (2.7%) were stage T4a. A dose of 45Gy in 1.8Gy fractions was administered to the whole pelvis 5 days/week over 5 weeks. A concomitant boost limited to the bladder tumor area plus margin or whole bladder of 22.5Gy in 1.5Gy fractions was administered from weeks 3×5. Thus, irradiation totalled 67.5Gy over 5 weeks. The interfraction interval was ≥6h/treatment day. We assessed prognostic factors for overall survival (OS), cause-specific survival (CSS) and relapse-free survival (RFS).
RESULTS: Median follow-up was 46.2 months (range 4.7-155.7 months). Median overall survival was 27 months (95% CI:21-33 months). In this study, 146 (77.7%) patients had complete response, 39 (20.7%) had residual disease and 4 (1.6%) had progressive disease. The mean 3-, 5- and 10-year OS rates were respectively 41.2% (S.E.±0.036), 29% (S.E.±0.034), and 13.8% (S.E.±0.031). Significant prognostic factors for OS and CSS, by multivariate analysis, were tumor T-stage and urothelial obstruction.
CONCLUSION: This CBRT protocol provided excellent results with a high complete response rate and good tolerance. This approach may therefore be particularly appropriate for elderly patients with invasive bladder cancer.
| Errataetall: |
ErratumIn: J Geriatr Oncol. 2017 Mar;8(2):148. - PMID 28216387 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:6 |
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| Enthalten in: |
Journal of geriatric oncology - 6(2015), 4 vom: 11. Juli, Seite 316-23 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Canyilmaz, Emine [VerfasserIn] |
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| Links: |
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| Themen: |
Bladder cancer |
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| Anmerkungen: |
Date Completed 12.05.2016 Date Revised 02.12.2018 published: Print-Electronic ErratumIn: J Geriatr Oncol. 2017 Mar;8(2):148. - PMID 28216387 Citation Status MEDLINE |
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| doi: |
10.1016/j.jgo.2015.04.004 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM248865072 |
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| 500 | |a ErratumIn: J Geriatr Oncol. 2017 Mar;8(2):148. - PMID 28216387 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2015 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVES: To evaluate the long-term clinical efficacy and toxicity of concomitant boost radiotherapy (CBRT) in elderly patients with invasive bladder cancer | ||
| 520 | |a METHODS AND MATERIALS: Elderly patients (n=188; mean 75-year-old, range 70-91 years; 88.3% male/11.7% female) with T1-T4a bladder carcinoma were irradiated with CBRT. A total of 24 (12.8%) patients were diagnosed at stage T1, 117 (62.2%) were at stage T2, 28 (14.9%) at were stage T3a, 14 (7.4%) were stage T3b, and 5 (2.7%) were stage T4a. A dose of 45Gy in 1.8Gy fractions was administered to the whole pelvis 5 days/week over 5 weeks. A concomitant boost limited to the bladder tumor area plus margin or whole bladder of 22.5Gy in 1.5Gy fractions was administered from weeks 3×5. Thus, irradiation totalled 67.5Gy over 5 weeks. The interfraction interval was ≥6h/treatment day. We assessed prognostic factors for overall survival (OS), cause-specific survival (CSS) and relapse-free survival (RFS) | ||
| 520 | |a RESULTS: Median follow-up was 46.2 months (range 4.7-155.7 months). Median overall survival was 27 months (95% CI:21-33 months). In this study, 146 (77.7%) patients had complete response, 39 (20.7%) had residual disease and 4 (1.6%) had progressive disease. The mean 3-, 5- and 10-year OS rates were respectively 41.2% (S.E.±0.036), 29% (S.E.±0.034), and 13.8% (S.E.±0.031). Significant prognostic factors for OS and CSS, by multivariate analysis, were tumor T-stage and urothelial obstruction | ||
| 520 | |a CONCLUSION: This CBRT protocol provided excellent results with a high complete response rate and good tolerance. This approach may therefore be particularly appropriate for elderly patients with invasive bladder cancer | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Bladder cancer | |
| 650 | 4 | |a Concomitant boost | |
| 650 | 4 | |a Elderly patients | |
| 650 | 4 | |a Radiotherapy | |
| 700 | 1 | |a Yoney, Adnan |e verfasserin |4 aut | |
| 700 | 1 | |a Serdar, Lasif |e verfasserin |4 aut | |
| 700 | 1 | |a Uslu, Gonca Hanedan |e verfasserin |4 aut | |
| 700 | 1 | |a Aynaci, Ozlem |e verfasserin |4 aut | |
| 700 | 1 | |a Haciislamoglu, Emel |e verfasserin |4 aut | |
| 700 | 1 | |a Yavuz, Melek Nur |e verfasserin |4 aut | |
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