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  • Title: Radical radiotherapy with salvage surgery for invasive bladder cancer: results following a reduction in radiation dose.
    Author: Whillis D, Howard GC, Kerr GR, Fowler J, Hargreave TB, Chisholm GD.
    Journal: J R Coll Surg Edinb; 1992 Feb; 37(1):42-5. PubMed ID: 1573607.
    Abstract:
    The management of invasive bladder cancer in Edinburgh, as in many other centres in the UK, has been by radical radiotherapy, with cystectomy reserved for local treatment failure or relapse. A review of the results of this policy in 1987 highlighted what was felt to be an unacceptably severe morbidity rate of 15%. The dose of radiation was therefore reduced from 55 Gy in 20 daily fractions to 52.5 Gy. Forty of 80 patients (50%) treated in this way have achieved a complete response at 6 months which is a similar response rate to that in previous reports. In addition, ten of 23 frail or elderly patients (43%) achieved a complete response with a lower dose of 50 Gy given as a split course over 7 weeks. Eighteen patients have had a salvage cystectomy, and 12 of 18 (67%) are alive and disease-free. Although follow-up is short, to date toxicity has been reduced, and our results support our decision to reduce the radiation dose.
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