C C E Koning1, L E C M Blank2, C Koedooder2, R M van Os2, M van de Kar2, E Jansen2, J J Battermann3, M Beijert4, C Gernaat5, K A M van Herpen6, C Hoekstra7, S Horenblas8, J J Jobsen5, A D G Krol9, M L M Lybeert10, I E W van Onna11, R C M Pelger12, P Poortmans13, F J Pos8, E van der Steen-Banasik14, A Slot15, A Visser14, B R Pieters2. 1. Department of Radiation Oncology, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam. Electronic address: c.c.koning@amc.uva.nl. 2. Department of Radiation Oncology, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam. 3. Departments of Radiation Oncology and Urology, University Medical Centre Utrecht, Utrecht. 4. Department of Radiation Oncology, University Medical Centre Groningen, Groningen. 5. Department of Radiation Oncology, Medisch Spectrum Twente, Enschede. 6. TweeSteden Hospital, Department of Urology, Tilburg. 7. Radiotherapeutic Institute RISO, Department of Radiation Oncology, Deventer. 8. The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Departments of Urology and Radiation Oncology, Amsterdam. 9. Department of Radiation Oncology, University Medical Centre Leiden, Leiden. 10. Department of Radiation Oncology, Catharina Hospital Eindhoven. 11. Amphia Hospital, Department of Urology, Breda. 12. Department of Urology, University Medical Centre Leiden, Leiden. 13. Institute Verbeeten, Department of Radiation Oncology, Tilburg. 14. Arnhem Radiotherapeutic Institute (ARTI), Arnhem. 15. Radiotherapeutic Institute Friesland (RIF), Leeuwarden, The Netherlands.
Abstract
BACKGROUND: Several French, Belgian and Dutch radiation oncologists have reported good results with the combination of limited surgery after external beam radiotherapy (EBRT) followed by brachytherapy in early-stage muscle-invasive bladder cancer. PATIENTS AND METHODS: Data from 12 of 13 departments which are using this approach have been collected retrospectively, in a multicenter database, resulting in 1040 patients: 811 males and 229 females with a median age of 66 years, range 28-92 years. Results were analyzed according to tumor stage and diameter, histology grade, age and brachytherapy technique, continuous low-dose rate (CLDR) and pulsed dose rate (PDR). RESULTS: At 1, 3 and 5 years, the local recurrence-free probability was 91%, 80% and 75%, metastasis-free probability was 91%, 80% and 74%, disease-free probability was 85%, 68% and 61% and overall survival probability was 91%, 74% and 62%, respectively. The differences in the outcome between the contributing departments were small. After multivariate analysis, the only factor influencing the local control rate was the brachytherapy technique. Toxicity consisted mainly of 24 fistula, 144 ulcers/necroses and 93 other types. CONCLUSIONS: EBRT followed by brachytherapy, combined with limited surgery, offers excellent results in terms of bladder sparing for selected groups of patients suffering from bladder cancer.
BACKGROUND: Several French, Belgian and Dutch radiation oncologists have reported good results with the combination of limited surgery after external beam radiotherapy (EBRT) followed by brachytherapy in early-stage muscle-invasive bladder cancer. PATIENTS AND METHODS: Data from 12 of 13 departments which are using this approach have been collected retrospectively, in a multicenter database, resulting in 1040 patients: 811 males and 229 females with a median age of 66 years, range 28-92 years. Results were analyzed according to tumor stage and diameter, histology grade, age and brachytherapy technique, continuous low-dose rate (CLDR) and pulsed dose rate (PDR). RESULTS: At 1, 3 and 5 years, the local recurrence-free probability was 91%, 80% and 75%, metastasis-free probability was 91%, 80% and 74%, disease-free probability was 85%, 68% and 61% and overall survival probability was 91%, 74% and 62%, respectively. The differences in the outcome between the contributing departments were small. After multivariate analysis, the only factor influencing the local control rate was the brachytherapy technique. Toxicity consisted mainly of 24 fistula, 144 ulcers/necroses and 93 other types. CONCLUSIONS: EBRT followed by brachytherapy, combined with limited surgery, offers excellent results in terms of bladder sparing for selected groups of patients suffering from bladder cancer.
Authors: Brian V Balgobind; Kees Koedooder; Diego Ordoñez Zúñiga; Raquel Dávila Fajardo; Coen R N Rasch; Bradley R Pieters Journal: Br J Radiol Date: 2015-08-20 Impact factor: 3.039
Authors: Annemieke Nap-van Klinken; Saskia J E A Bus; Theodorus G Janssen; Marion P R Van Gellekom; Geert Smits; Elzbieta Van der Steen-Banasik Journal: J Contemp Brachytherapy Date: 2014-09-23
Authors: Elzbieta Van der Steen-Banasik; Bernard Oosterveld; Geert Smits; Els Atema; Marion Van Gellekom; Marie Haverkort; Andries Visser Journal: J Contemp Brachytherapy Date: 2020-12-16