Long-term results of a concomitant boost radiotherapy technique for elderly patients with muscle-ınvasive bladder cancer

Canyılmaz, Emine; Yöney, Adnan; Serdar, Lasif; Uslu, Gonca Hanedan; Aynacı, Osman; Haciislamoglu, Emel; Bahat, Zümrüt; Yavuz, Mustafa

doi:10.1016/j.jgo.2015.04.004

Cited by 7 publications

(10 citation statements)

References 37 publications

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“…NMIBC is characterized by high recurrence and progression rates, and the probability of recurrence ranges from 15% to 61% at 1 year and 31% to 78% at 5 years; furthermore, 1%–45% of NMIBCs will progress into muscle‐invasive bladder cancer (MIBC) at 5 years 3 . Patients with MIBC have much poorer survival rates (29%–57% at 5 years) than NMIBC 4,5 . Radical cystectomy, the standard treatment for MIBC, negatively impacts the quality of life, emotional function, and cognitive function of patients 6 .…”

Section: Introductionmentioning

confidence: 99%

“…3 Patients with MIBC have much poorer survival rates (29%-57% at 5 years) than NMIBC. 4,5 Radical cystectomy, the standard treatment for MIBC, negatively impacts the quality of life, emotional function, and cognitive function of patients. 6 Therefore, it is essential to investigate strategies for reducing the recurrence and progression rates of NMIBC.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of intravesical therapies on the prevention of recurrence and progression of non‐muscle‐invasive bladder cancer: A systematic review and network meta‐analysis

Xia

et al. 2020

Cancer Medicine

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Intravesical instillation therapy is the mainstay of prophylaxis of tumor recurrence and progression in non‐muscle‐invasive bladder cancer. However, there is no study evaluating the superiority of monotherapy. The aim of this study is to compare the efficacy of preventing recurrence and progression of intravesical monotherapies via network meta‐analysis (NMA) of randomized controlled trials. Database searches were conducted on Embase, Ovid Medline, Web of Science, ScienceDirect, Cochrane Library, and ClinicalTrials.com from the time of establishment to February 6, 2020. The monotherapies included Bacille Calmette‐Guérin (BCG), mitomycin C (MMC), interferon (IFN), adriamycin, epirubicin, gemcitabine (GEM), and thiotepa (THP). A Bayesian consistency network model was generated under a random‐effects model. The superiority of therapy was identified based on the surface under the cumulative ranking curve (SUCRA). Fifty‐seven studies with 12462 patients are included. NMA shows that GEM (SUCRA = 0.92), BCG (SUCRA = 0.82), and IFN (SUCRA = 0.78) are the top three effective drugs to reduce recurrence. GEM (SUCRA = 0.87) is the most effective therapy to prevent progress, followed by BCG, MMC, THP, and IFN with similar efficacy. Subgroup analysis of pairwise meta‐analysis and NMA was performed on publication year, trial initiation year, study origin, center involvement, sample size, drug schedule, tumor characteristics, and trial quality to address confounding factors, which suggests the robustness of the results with stable effect sizes. Network meta‐regression also indicates consistent rank by analyzing year, sample size, and quality. Compared with BCG, GEM is also a promising therapy with favorable efficacy to reduce tumor recurrence and progression. IFN and MMC could be alternative therapies for BCG with slightly inferior efficacy in recurrence prevention and similar efficacy in progression prevention. However, the results of this study should be treated with caution since most of the included studies are of moderate to high risk of bias.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of intravesical therapies on the prevention of recurrence and progression of non‐muscle‐invasive bladder cancer: A systematic review and network meta‐analysis

Xia

et al. 2020

Cancer Medicine

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“…Radiotherapy is an alternative to cystectomy in patients with muscle-invasive bladder cancer (8)(9)(10)(11). Particularly for elderly patients with invasive bladder cancer, radiotherapy can provide excellent results with a high complete response rate and good tolerability (12,13). The main pathologic type of bladder cancer is urothelial carcinoma.…”

Section: Surgery Is the Preferred Approach For Treating Nonmetastaticmentioning

confidence: 99%

Radiation therapy for nonmetastatic medically inoperable upper-tract urothelial carcinoma

et al. 2021

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Background: The standard management for upper urinary tract urothelial carcinoma (UTUC) is radical nephroureterectomy (RNU). However, some patients cannot undergo this procedure for several reasons, such as unresectable disease, old age, and multiple comorbidities. Our study explored the potential safety and effectiveness of radiotherapy as a curative treatment for UTUC patients unfit for surgery. Methods:The data of patients treated with radiotherapy between December 2017 and November 2019 were retrospectively reviewed. For the literature review, computerized PubMed Medline, Index Medicus, and Web of Science databases and reference lists from the identified publications of interest were used. And "upper-tract urothelial carcinoma" and "radiotherapy" were used as key words in the search. Results:We describe 8 patients with UTUC who were treated with radiotherapy. The median follow-up time was 13.5 months (range, 8.6-30.9 months). Local tumor control was achieved in all patients. However, distant metastases were observed in 2 patients with T3-4/N+ status. One patient had T4 status and the other had N2+ status. The patients died of tumor progression at 15.0 and 17.7 months. In addition, the other 6 patients who were still alive had relatively early-stage tumors without nodal involvement. Regarding acute toxicity, according to the CTCAE v5.0, mild side effects were noted, including grade 1 nausea and diarrhea.Four patients developed mild anemia, generally of grade 1-2. One patient experienced grade 3 anemia, but it was manageable and improved with symptomatic support. In addition, no grade 4 acute or late toxicities were observed. No significant long-term impairment of renal function occurred.Conclusions: For patients with nonmetastatic UTUC who are not suitable for surgery, radiotherapy is a safe treatment and can achieve good local tumor control.

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“…Bladder cancer is categorized as non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC) based on the results of clinical T staging [ 2 ], and both groups have different clinical outcomes and therapeutic options. NMIBC is generally associated with a 5‐year survival rate of > 88% [ 3 ]. However, it is characterized by a high recurrence rate.…”

Section: Introductionmentioning

confidence: 99%

Biological distinction between grades 2 and 3 with respect to intravesical recurrence in T1 high-grade bladder tumors: a retrospective study

et al. 2022

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Background The pathological grading system for non-muscle-invasive bladder cancer is based on the WHO 2004/2016 classification system (low-grade: LG/high-grade: HG) and the WHO 1973 classification system (Grade 1: G1/Grade 2: G2/Grade 3: G3). Recently, the usefulness of combining both systems and classifying the tumors as LG/G1, LG/G2, HG/G2, and HG/G3 has been demonstrated. In this study, we compared the prognosis of intravesical recurrence in relation to different treatment intensities between HG/G2 and HG/G3 bladder cancers. Methods We retrospectively evaluated the clinical and therapeutic outcomes of 145 patients diagnosed with T1 HG bladder cancer between 2000 and 2020. We classified 145 patients into three groups: (1) patients with T1 HG/G2 and HG/G3 who received intravesical instillation therapy (n = 76), (2) patients with T1 HG/G2 who did not receive intravesical instillation therapy (n = 32), and (3) patients with T1 HG/G3 who did not receive intravesical instillation therapy (n = 37). Results The median intravesical recurrence-free survival for all patients was 34.2 months. The number of tumors, the presence of intravesical instillation therapy, and tumor grade were significant prognostic factors for intravesical recurrence in all cases. Groups 2 and 3 showed significantly worse prognosis than group 1 in the multivariate analysis. Conclusions Regarding intravesical recurrence, intravesical instillation therapy is necessary for both T1 HG/G3 and T1 HG/G2 bladder cancers.

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Long-term results of a concomitant boost radiotherapy technique for elderly patients with muscle-ınvasive bladder cancer

Cited by 7 publications

References 37 publications

Efficacy of intravesical therapies on the prevention of recurrence and progression of non‐muscle‐invasive bladder cancer: A systematic review and network meta‐analysis

Efficacy of intravesical therapies on the prevention of recurrence and progression of non‐muscle‐invasive bladder cancer: A systematic review and network meta‐analysis

Radiation therapy for nonmetastatic medically inoperable upper-tract urothelial carcinoma

Biological distinction between grades 2 and 3 with respect to intravesical recurrence in T1 high-grade bladder tumors: a retrospective study

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