title: Split course radiotherapy for bladder cancer in elderly unfit patients.
abstract: Between 1980 and 1987, 89 patients with T1-T4 carcinoma of the bladder were treated with a split course of external beam radiotherapy. All patients were felt to be unsuitable for a prolonged course of radical radiotherapy because of age and/or poor general health. The intention was to provide local control. The majority of patients were treated with 10-12 fractions, with a mean dose of 45 Gy (range 31.5-57.7), within a mean overall time of 48 days. Of the 89 patients only 62 were assessable with a median follow-up of 110 months (range 64-157). In the remainder, poor health, poor performance status, or early (< 3 months) death did not allow assessment of tumour control. Complete remission was achieved in 28/89 (31%) patients. This was highly dependent on T stage: 56% T1/T2, 30% T3a/T3b, 5% T4. Median survival for patients with Stage T1/T2, T3a/T3b and T4 disease was 22, 10 and 8 months respectively. Acute grade 1-2 radiation reactions occurred in 60% of these patients, and only 5/62 (8%) experienced grade 2-3 late complications, assessed according to the RTOG scoring system. No patient had more severe treatment related morbidity.
authors.affiliation: Yorkshire Regional Centre for Cancer Treatment, Department of Radiotherapy and Oncology, Cookridge Hospital, Leeds, UK.
authors.forename: J
authors.initials: J
authors.lastname: Vrouvas
authors.forename: D
authors.initials: D
authors.lastname: Dodwell
authors.forename: D
authors.initials: D
authors.lastname: Ash
authors.forename: H
authors.initials: H
authors.lastname: Probst
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011829:Radiation Dosage; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D012074:Remission Induction; D015996:Survival Rate; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000532:radiotherapy*