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Brachytherapy after external beam radiotherapy and limited surgery preserves bladders for patients with solitary pT1-pT3 bladder tumors

Koning, C. C. E., Blank, L. E. C. M., Koedooder, C., van Os, R. M., van de Kar, M., Jansen, E., Battermann, J. J., Beijert, M., Gernaat, C., van Herpen, K. A. M., Hoekstra, C., Horenblas, S., Jobsen, J. J., Krol, A. D. G., Lybeert, M. L. M., van Onna, I. E. W., Pelger, R. C. M., Poortmans, P., Pos, F. J., van der Steen-Banasik, E., Slot, A., Visser, A. & Pieters, B. R., 2012, In : Annals of Oncology. 23, 11, p. 2948-2953 6 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • C.C.E. Koning
  • L. E. C. M. Blank
  • C. Koedooder
  • R.M. van Os
  • M. van de Kar
  • E. Jansen
  • J. J. Battermann
  • M. Beijert
  • C. Gernaat
  • K. A. M. van Herpen
  • C. Hoekstra
  • S. Horenblas
  • J. J. Jobsen
  • A. D. G. Krol
  • M. L. M. Lybeert
  • I. E. W. van Onna
  • R. C. M. Pelger
  • P. Poortmans
  • F. J. Pos
  • E. van der Steen-Banasik
  • A. Slot
  • A. Visser
  • B. R. Pieters

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.

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).

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.

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.

Original languageEnglish
Pages (from-to)2948-2953
Number of pages6
JournalAnnals of Oncology
Volume23
Issue number11
Publication statusPublished - 2012

    Keywords

  • bladder-preserving, bladder cancer, brachytherapy, multicenter data, COMBINED-MODALITY TREATMENT, MATCHED CONTROL POPULATION, ORGAN PRESERVATION, RADICAL CYSTECTOMY, INTERSTITIAL IR-192, RADIATION-THERAPY, CANCER, CONSERVATION, SUBSTITUTION, CHEMOTHERAPY

ID: 5706907