TITLE:
Bladder-Sparing Approach with Radiotherapy in Patients with Small Cell Carcinoma of the Bladder
AUTHORS:
Hiroko Akamatsu, Takuma Nomiya, Mayumi Harada, Ibuki Oota, Mayumi Ichikawa, Misako Miwa, Yuuki Kuroda, Kenji Takai, Akira Anbai, Hideo Kawaguchi, Yoshihiro Takai, Kenji Nemoto
KEYWORDS:
Small Cell Carcinoma of the Bladder, Radiotherapy, Cystectomy
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.5 No.8,
July
17,
2014
ABSTRACT:
Small cell carcinoma
(SCCB) of the bladder is rare and has a poor prognosis. Because of its rarity,
gold standard care has not been established. The purpose of this study was to
analyze the feasibility of a bladder-sparing approach. Data for treatments and
outcomes in patients with a diagnosis of SCCB who received bladder-sparing
treatment in our facility in the period from February 2007 to August 2012 were
retrospectively analyzed. Six eligible patients received definitive
radiotherapy in the cancer network of Tohoku region. Mean age of the patients
was 69.5 years (range: 44 - 83 years), and median follow-up period was 29.2
months (range: 4.1 - 54.5 months). The mean dose was 60 Gy (range: 60 to 63
Gy), and 1.2 - 2.0 Gy was given per fraction. The initial CTV was the whole
pelvis or the small pelvis, and it was shrunk to the bladder or tumor as a
boost. The 1-year and 3-year overall survival rates were 83.3% and 55.6%,
respectively. The 1-year and 3-year local control rates were both 80.0%. Only
one patient had local failure. Recurrence or metastasis in sites other than the
brain occurred in three (50%) of the patients after primary treatment. Two of those
patients did not receive any chemotherapy. None of the patients had serious
toxicities, and the bladder could be preserved in all patients. In this study,
radiotherapy was effective for patients with SCCB. There was no recurrence in
the bladder, and it was possible to preserve the bladder in all patients.
Distant metastases were observed frequently, and chemotherapy was considered to
be essential. Local treatment with radiotherapy has an important role from the
point of view of the patient’s QOL.