TITLE:
Postoperative Radiotherapy in Bladder Cancer Patients: 5-Year Institutional Experience of National Cancer Institute, Cairo University
AUTHORS:
Azza M. Nasr, Magda El Mongi, Mamdouh Hagag, Manar M. Moneer, Hisham El Hossieny, Azza Taher, Sherif Magdy
KEYWORDS:
Bladder Cancer, Radiotherapy, Pelvic Irradiation
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.7,
July
16,
2015
ABSTRACT: Purpose: Adjuvant radiation therapy could reduce loco regional failure,
but currently has no defined role because of previously reported morbidity.
NCI-Cairo routine work is to give adjuvant PORT for locally advanced bladder
carcinoma patients. The aim of this work is to re-evaluate this protocol
regarding its effect on prognosis and complications. Patients and Method: A
retrospective study included 208 patients with pathologically proven bladder
cancer who presented to the NCI, Cairo University from 2007-2011. All of them
underwent RC with bilateral PLND followed by conventional post-operative
radiotherapy in 2 - 6 weeks after surgery for 5000 cGy in 25 fractions, over 5
weeks using 2D technique. Analysis of data from their files was done for the
treatment results, prognostic factors and complications. Results: Three years
overall survival (OS) and disease free survival (DFS) for the whole group was ~60%,
and 54% respectively in favour of the female gender, non-smokers, Squamous cell
carcinoma patients, low grade tumours (grade 1 and 2) negative margins, N0,
pT2b and early stage group showed the best prognoses. The 3 years metastases
free survival (MFS) was ~71%. Only four factors showed a significant relation
with the MFS which were the grade, LN status, T-stage and group staging. The
local recurrence rate (LRC) at 2 years for the whole group was ~95% and 94% at
3 years. Only surgical margin status and extent of LN dissection had a
significant impact on the LRC. Conclusions: Adjuvant radiotherapy shows
sustained improvement in the loco regional control, and should be recommended
for patients with locally advanced disease especially those with less than 10
dissected lymph nodes and those with positive margins.