Radiotherapy in Carcinoma of the Bladder: Possible Complications and Their Prevention

Bloedorn, Fernando G.; Young, John; Cuccia, Carlo A.; Mercado, Raul; Wizenberg, Morris J.

doi:10.1148/79.4.576

Cited by 19 publications

(3 citation statements)

References 5 publications

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“…Radiation damage should be regarded as a potentially progressive disease. The factors which may predispose to the development of intestinal complications have been suggested by several authors, including Bloedorn, Young, Cuccia, Mercado, and Wizenberg (1962), Graham and Villalba (1963), and DeCosse and others also been suggested as a factor. The equal incidence of pre-radiotherapy abdominal operations (or pelvic sepsis) in patients with small-bowel complications and in those sustaining damage to the already immobile rectum suggests that adhesions were not of aetiological importance in this series.…”

Section: Discussionmentioning

confidence: 91%

The intestinal complications of radiotherapy

Wellwood

Jackson

1973

Journal of British Surgery

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The clinical features of 38 patients with intestinal complications after radiotherapy are recorded. Intestinal complications are commonly progressive and in this series led to the death of 14 patients (37 per cent). Nine of these patients had no sign of recurrent tumour. ‘Spontaneous’ necrosis of the irradiated bowel and necrosis of intestinal anastomoses after surgical operation carried a particularly high mortality. Only 3 patients (8 per cent) became completely asymptomatic after treatment of their bowel disease. Apparently localized radiation lesions in the small bowel were sometimes associated with severe malabsorption. Radiographs showed distinctive radiological patterns in the small bowel. A combined radiotherapy/surgical follow‐up clinic is advocated.

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Section: Discussionmentioning

confidence: 91%

The intestinal complications of radiotherapy

Wellwood

Jackson

1973

Journal of British Surgery

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“…These patients may represent a group with a greater risk of developing postirradiation bladder complications because of their underlying disease. The bladder capacity of these patients was reduced to 60 ml or less, compared to the normal capacity of 350-550 ml of the adult bladder [5,6]. Late bladder complications were reported in 2.7% of women treated with combined external beam and interstitial irradiation for neoplasms of the uterus, including carcinoma and leiomyoma [7], The majority of these reactions were severe.…”

Section: Discussionmentioning

confidence: 99%

Incontinence of Urine and Stool following Treatment in Infancy for Embryonal Rhabdomyosarcoma

Wu¹,

Dm²,

Pk³

et al. 1983

Oncology

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A vaginal rhabdomyosarcoma which occurred in an 11-month-old infant was treated with conservative surgical excision, radiation therapy and chemotherapy. The long-term sequelae of this therapy included rectal stenosis, which required surgical correction, and urinary incontinence. The patient may have had fewer long-term complications if a more aggressive surgical procedure had been performed at the time of diagnosis because a gross and microscopically complete excision would have obviated the need of postoperative pelvic irradiation. Strong consideration of total surgical excision should be given to infants with pelvic rhabdomyosarcoma.

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“…Recent improvements in techniques have also contributed towards this trend for radiotherapy and it is now possible to give a higher radiation dose without risk of skin damage. However, it is still difficult to screen other pelvic viscera and they may develop complications owing to radiation damage (Riches and Windeyer, 1960;Bloedorn, Young, Cuccia, Mercado, and Wizenberg, 1962; Caldwell, Bagshaw, and Kaplan, 1967). There is also a risk that radiotherapeutic complications may be mistaken for spread of the primary tumour and the patient denied further treatment.…”

mentioning

confidence: 99%

Visceral complications of supervoltage radiotherapy for carcinoma of the bladder

Ram

1970

Journal of British Surgery

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SUMMARYThirteen of 65 patients suffering from carcinoma of the bladder and treated by supervoltage radiotherapy developed late visceral complications. In 8 patients these lesions were in the bladder and in 7 the gastrointestinal tract was involved. The factors that are responsible for these lesions and the problems in their management are discussed.THE choice of treatment for carcinoma of the bladder may be a difficult problem and both surgery and radiotherapy have a place (Riches, 1963). Radiotherapy has been preferred for tumours which involve most of the mucosa of the bladder, are infiltrating deeply, or are anaplastic. Surgery in such cases requires a total cystectomy and urinary diversion and this procedure may be hazardous, although the mortality in experienced units is less than 5 per cent (Cordonnier, 1968). Recent improvements in techniques have also contributed towards this trend for radiotherapy and it is now possible to give a higher radiation dose without risk of skin damage. However, it is still difficult to screen other pelvic viscera and they may develop complications owing to radiation damage (Riches and Windeyer, 1960;Bloedorn, Young, Cuccia, Mercado, and Wizenberg, 1962; Caldwell, Bagshaw, and Kaplan, 1967). There is also a risk that radiotherapeutic complications may be mistaken for spread of the primary tumour and the patient denied further treatment. Many of these complications present as general surgical problems. CLINICAL MATERIALFrom 1960 to 1967, 65 patients with carcinoma of the bladder, admitted to the Urological Unit at the Hammersmith Hospital, were treated by supervoltage radiotherapy. Patients treated by surgery alone or patients referred to the Radiotherapy Unit from other hospitals were excluded from this study.Radiotherapy was given to patients in whom the tumour was ( a ) clinically or histologically infiltrating beyond the muscle, (b) multiple and not easily amenable to surgery, or (c) histologically poorly differentiated. Radiotherapy was also given where surgery was contra-indicated because of poor general condition.The patients were treated on the Linear Accelerator (8MeV.) and received a tumour dose of 4000-6250rads. The average duration of treatment was 4 weeks. The four-field technique was used except when there was a recent suprapubic scar, when three fields were used. The details of technique have been described previously (Morrison and Deeley, 1965).All patients were seen at regular intervals by both the Urological and the Radiotherapy Units. There was a minimal follow-up of 15 months. During treatment most patients develop mild to moderate symptoms of malaise, nausea, diarrhoea, frequency of micturition, and dysuria and these usually settle within a month after completion of treatment. Late complications were attributed to radiotherapy only if the histology of the lesions ( a ) showed no evidence of tumour and (b) showed radiation changes. Thirteen patients developed late complications (TabZe Z) and t developed t major lesions each, so that a total of 15 visceral co...

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Radiotherapy in Carcinoma of the Bladder: Possible Complications and Their Prevention

Cited by 19 publications

References 5 publications

The intestinal complications of radiotherapy

The intestinal complications of radiotherapy

Incontinence of Urine and Stool following Treatment in Infancy for Embryonal Rhabdomyosarcoma

Visceral complications of supervoltage radiotherapy for carcinoma of the bladder

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