Literature DB >> 16376486

Radical radiotherapy for invasive bladder cancer: What dose and fractionation schedule to choose?

Floris J Pos1, Guus Hart, Christoph Schneider, Peter Sminia.   

Abstract

PURPOSE: To establish the alpha/beta ratio of bladder cancer from different radiotherapy schedules reported in the literature and provide guidelines for the design of new treatment schemes. METHODS AND MATERIALS: Ten external beam radiotherapy (EBRT) and five brachytherapy schedules were selected. The biologically effective dose (BED) of each schedule was calculated. Logistic modeling was used to describe the relationship between 3-year local control (LC3y) and BED.
RESULTS: The estimated alpha/beta ratio was 13 Gy (95% confidence interval [CI], 2.5-69 Gy) for EBRT and 24 Gy (95% CI, 1.3-460 Gy) for EBRT and brachytherapy combined. There is evidence for an overall dose-response relationship. After an increase in total dose of 10 Gy, the odds of LC3y increase by a factor of 1.44 (95% CI, 1.23-1.70) for EBRT and 1.47 (95% CI, 1.25-1.72) for the data sets of EBRT and brachytherapy combined.
CONCLUSION: With the clinical data currently available, a reliable estimation of the alpha/beta ratio for bladder cancer is not feasible. It seems reasonable to use a conventional alpha/beta ratio of 10-15 Gy. Dose escalation could significantly increase local control. There is no evidence to support short overall treatment times or large fraction sizes in radiotherapy for bladder cancer.

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Year:  2006        PMID: 16376486     DOI: 10.1016/j.ijrobp.2005.09.023

Source DB:  PubMed          Journal:  Int J Radiat Oncol Biol Phys        ISSN: 0360-3016            Impact factor:   7.038


  21 in total

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Review 2.  Image-guided radiation therapy for muscle-invasive bladder cancer.

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3.  Treatment results of radiation therapy for muscle-invasive bladder cancer.

Authors:  Tanja Langsenlehner; Carmen Döller; Franz Quehenberger; Heidi Stranzl-Lawatsch; Uwe Langsenlehner; Karl Pummer; Karin S Kapp
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4.  Muscle-invasive bladder cancer treated with TURB followed by concomitant boost with small reduction of radiotherapy field with or without of chemotherapy.

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5.  Chemoradiotherapy in octogenarians as primary treatment for muscle-invasive bladder cancer.

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6.  Hypofractionated palliative radiotherapy for bladder cancer.

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7.  Radiotherapy in muscle-invasive bladder cancer: the latest research progress and clinical application.

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Review 8.  Radio-chemotherapy for bladder cancer: Contribution of chemotherapy on local control.

Authors:  George A Plataniotis; Roger G Dale
Journal:  World J Radiol       Date:  2013-08-28

Review 9.  Radiation therapy in urinary cancer: state of the art and perspective.

Authors:  M Troiano; P Corsa; A Raguso; S Cossa; M Piombino; G Guglielmi; S Parisi
Journal:  Radiol Med       Date:  2008-12-11       Impact factor: 3.469

10.  Bladder preservation by concurrent chemoradiation for muscle-invasive bladder cancer: Applicability in low-income countries.

Authors:  Jamal Khader; Naim Farah; Ahmed Salem
Journal:  Rep Pract Oncol Radiother       Date:  2011-05-23
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