Clinical evaluation of intraoperative radiotherapy for carcinoma of the urinary bladder.

Intraoperative radiotherapy using one shot high dose electron irradiation was performed for 116 bladder cancer patients as a radical means of treatment for superficial bladder cancer. Additional fractionated external supervoltage irradiation covering the whole bladder was given in most of the cases. The one-, three-, and five-year survival rates were 100%, 100%, and 96.3% for T1 cases and 100%, 87.2%, and 61.6% for T2 cases, respectively. Heterotropic recurrences in the bladder were 5.3% within one year, 9.4% within two years, and 19.3% within five years, respectively. Normal vesical function was well preserved except in five patients who underwent total cystectomy subsequently because of multiple recurrences after radiotherapy and one patient who underwent urinary diversion because of contracted bladder and progressive bilateral hydronephrosis. Intraoperative radiotherapy was established as a reliable and superior method for the treatment of superficial bladder cancer because of the low recurrence rate and good preservation of vesical functions after treatment.