Split course radical radiotherapy for bladder cancer in the elderly: nonsense or commonsense? A report of 76 patients.
The role of split course radical radiotherapy in bladder cancer is controversial. We have pursued such a policy in elderly patients in view of the unpredictable toxicity of radical radiotherapy in this group. Between 1987 and 1992, 76 patients were treated in this way, with 2 weeks' treatment followed by a 3-week gap. Patients were then reassessed and, if considered fit enough, a further 2 weeks of treatment was given. Fifty-three patients (mean age 78.4 years) completed treatment and 23 (mean age 78 years) received phase 1 alone. Thirty-seven of 53 patients completing treatment has a follow-up cystoscopy at 6 months. Twenty-five percent of all patients, 36% of those completing treatment, and 51% of those undergoing cystoscopy, achieved a complete response. The reasons for not completing treatment and not being followed up cystoscopically are examined. We feel that this policy has a role in selected patients whose fitness to tolerate a conventional radical course of radiotherapy is in doubt.
Phillips
H A
HA
Department of Clinical Oncology, Western General Hospital, Edinburgh, UK.
Howard
G C
GC
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy; D002295:Carcinoma, Transitional Cell / Q000532:radiotherapy; D015331:Cohort Studies; D015653:Cystectomy; D003558:Cystoscopy; D005500:Follow-Up Studies; D006801:Humans; D018365:Neoplasm, Residual; D010166:Palliative Care; D011836:Radiation Tolerance; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy / Q000379:methods; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000532:radiotherapy*