Contemporary results of radical radiotherapy for bladder transitional cell carcinoma in a district general hospital with cancer-centre status.
OBJECTIVE
To assess the current efficacy and safety of definitive external beam radiotherapy (EBRT) in the treatment of invasive bladder transitional cell carcinoma (TCC) in a district general hospital with cancer-centre status.


METHODS
The case notes of all patients with bladder TCC undergoing EBRT with curative intent over an 8-year period (1988-95) were reviewed. Additional missing outcome data were collected.


RESULTS
In all, 120 patients (109 men; median age 70 years, range 34-90) underwent radical EBRT (40-65 Gy; fraction median=20) over the 8-year period. Staging, as assessed by examination under anaesthesia and computed tomography, was T1 in 16%, T2 in 43%, T3 in 38% and T4 in 3%. In 96 patients (80%) the tumour was poorly differentiated (G3). The overall morbidity at 12 months was 12%; proctitis occurred in nine patients (8%) and cystitis in five (4%). Sixty-seven patients (59%) developed a local recurrence and in 36 (30%) this was invasive. The overall median survival was 60 months. Thirty-three patients underwent salvage cystectomy with a subsequent median survival of 12.5 months.


CONCLUSIONS
Modern radical multifraction EBRT in invasive bladder TCC has a low morbidity, with an overall median survival of 5 years.
Bell
C R
CR
Department of Urology, The Royal Devon & Exeter NHS Trust.
Lydon
A
A
Kernick
V
V
Hong
A
A
Penn
C
C
Pocock
R D
RD
Stott
M A
MA
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities; D002295:Carcinoma, Transitional Cell / Q000532:radiotherapy*; D006767:Hospitals, District; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016019:Survival Analysis; D001749:Urinary Bladder Neoplasms / Q000532:radiotherapy*