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20.11.2017 | Research Article | Ausgabe 7/2018

Clinical and Translational Oncology 7/2018

Curative radiation therapy for very elderly bladder cancer patients with localized disease

Zeitschrift:
Clinical and Translational Oncology > Ausgabe 7/2018
Autoren:
M. Bonet, T. Bonfill, M. Nuñez, L. De Verdonces, E. Mur, E. Gallardo, L. Fernandez-Morales, A. Aguilar, J. Prats, M. Arenas
Wichtige Hinweise
The original version of this article was revised: In the original version of this article the figure captions of Figs. 1 and 2 were interchanged. The correct captions of Figs. 1 and 2 are listed below.
A correction to this article is available online at https://​doi.​org/​10.​1007/​s12094-018-1853-0.

Abstract

Purpose

To report the outcomes of a cohort of very elderly muscle-invasive bladder cancer (MIBC) patients treated with contemporary 3D-conformal radiation therapy (3D-CRT) with or without concurrent chemotherapy, after transurethral resection of bladder tumor (TURBT).

Methods

From February 2010 to January 2014, a total of 41 patients older than 75 years, with T2-3 N0-1 high-grade MIBC, a Karnofsky index (KI) of at least 90% and/or a Barthel scale score of at least 95, were treated with TURBT followed by radiotherapy (RT) with or without chemotherapy, and were prospectively followed-up.

Results

The mean age of patients was 82 years (range 76–88). Median follow-up was 47 months for surviving patients. Mean Charlson Comorbidity Index (CCI) score was 5 points. 28 patients (68.29%) were T2N0. All received 3D-CRT to a mean dose of 60 Gy (range 48.6–66 Gy), and chemotherapy was delivered to 34 patients (83%). Cause-specific survival (CSS) was 86 and 78.8% at 1 and 5 years, respectively. Patients achieving a complete response lived longer (48 vs 14 m, p = 0.036) than those with a progressive disease, who were more likely to die from cancer than from other causes (HR 3.865, IC95% 1.562–9.562). Dead patients had a longest treatment time (mean 56.78 vs 48.91 days, p = 0.019) than survivors.

Conclusion

RT with contemporary 3D-CRT techniques after TURBT for MIBC in elderly patients is feasible and well-tolerated. Achieving a maximal response and shortening the total radiation treatment time may improve outcomes and quality of life.

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