title: Improving and predicting radiosensitivity in muscle invasive bladder cancer.
abstract: OBJECTIVE
  Muscle invasive bladder cancer is a common urological malignancy with a relatively poor prognosis and 5-year survival rates ranging from 20% to 90%. We review methods of improving the outcome of this condition, with particular emphasis on the principal bladder preserving treatment modality of radiation therapy.
  
  
  METHODS
  We performed a literature search using MEDLINE and the ISI Web of Science using the keywords radiotherapy, radiosensitization and bladder neoplasia to ascertain the current status of radiation therapy and radiosensitizing agents in the treatment of muscle invasive bladder cancer.
  
  
  RESULTS
  Several methods aimed at improving outcome following radiation therapy for muscle invasive bladder cancer are described. These methods range from modifications in the application of radiation therapy to use of conventional radiosensitizing agents, such as accelerated radiotherapy with carbon dioxide, oxygen and nicotinamide, and finally to use of more novel agents that interact with oncogenic products. The use of assays that predict tumor sensitivity on an individual basis represents an additional potential method to improve prognosis following radiation therapy.
  
  
  CONCLUSIONS
  The ability to predict tumor radiosensitivity and the subsequent implementation of radiosensitizing techniques are likely to improve the results of treatment centered on radiation therapy, suggesting that bladder sparing approaches will remain a treatment option for muscle invasive bladder cancer.
authors.affiliation: University Division of Urology, Leicester General Hospital, Department of Oncology, University of Leicester and University Department of Oncology, Leicester Royal Infirmary, Leicester, United Kingdom.
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Colquhoun
authors.forename: George D D
authors.initials: GD
authors.lastname: Jones
authors.forename: Manar Al
authors.initials: MA
authors.lastname: Moneef
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Bowman
authors.forename: Roger C
authors.initials: RC
authors.lastname: Kockelbergh
authors.forename: R Paul
authors.initials: RP
authors.lastname: Symonds
authors.forename: Will P
authors.initials: WP
authors.lastname: Steward
authors.forename: J Kilian
authors.initials: JK
authors.lastname: Mellon
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000532:radiotherapy; D003131:Combined Modality Therapy; D006801:Humans; D009361:Neoplasm Invasiveness; D011379:Prognosis; D011836:Radiation Tolerance; D011838:Radiation-Sensitizing Agents / Q000008:administration & dosage; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D011838:Radiation-Sensitizing Agents