OBJECTIVE: To retrospectively analyse the efficacy and toxicity of conservative treatment for T1G3 and T2-3a bladder carcinoma and to compare the results with those obtained in a previous study using caesium implantation. PATIENTS AND METHODS: Between 1987 and 1990 12 patients with high-grade T1 tumours and 28 with T2-3a tumours were treated using this combined approach. All tumours were solitary with a diameter not exceeding 5 cm. Treatment consisted of transurethral resection, a course of external irradiation (30 Gy in 15 fractions) to the whole pelvis and an implant procedure. RESULTS: With a mean follow-up of 40 months (range 24-65) 31 patients remained free of disease and nine relapsed: three with distant metastases, two with bladder recurrence and four with combined bladder and distant relapse. Three patients showed tumour at the original site. The 5 years actuarial rate of local control was 84% with an overall 5 years actuarial survival of 86%. Early problems included bladder leakage, wound infection and psychological problems. Late complications in four patients, was transient ulceration at the implant side causing mild dysuria. CONCLUSIONS: Implantation with iridium is equally effective as with caesium but has significantly fewer complications.
OBJECTIVE: To retrospectively analyse the efficacy and toxicity of conservative treatment for T1G3 and T2-3a bladder carcinoma and to compare the results with those obtained in a previous study using caesium implantation. PATIENTS AND METHODS: Between 1987 and 1990 12 patients with high-grade T1 tumours and 28 with T2-3a tumours were treated using this combined approach. All tumours were solitary with a diameter not exceeding 5 cm. Treatment consisted of transurethral resection, a course of external irradiation (30 Gy in 15 fractions) to the whole pelvis and an implant procedure. RESULTS: With a mean follow-up of 40 months (range 24-65) 31 patients remained free of disease and nine relapsed: three with distant metastases, two with bladder recurrence and four with combined bladder and distant relapse. Three patients showed tumour at the original site. The 5 years actuarial rate of local control was 84% with an overall 5 years actuarial survival of 86%. Early problems included bladder leakage, wound infection and psychological problems. Late complications in four patients, was transient ulceration at the implant side causing mild dysuria. CONCLUSIONS: Implantation with iridium is equally effective as with caesium but has significantly fewer complications.
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