title: Concomitant boost radiotherapy for muscle invasive bladder cancer.
abstract: OBJECTIVE
  To evaluate the feasibility and efficacy of a concomitant partial bladder boost schedule in radiotherapy for invasive bladder cancer, coupling a limited boost volume with shortening of the overall treatment time.
  
  
  METHODS
  Between 1994 and 1999, 50 patients with a T2-T4 N0M0 transitional cell carcinoma of the bladder received radiotherapy delivered in a short overall treatment time with a concomitant boost technique. With this technique a dose of 40 Gy in 2-Gy fractions was administered to the small pelvis with a concomitant boost limited to the bladder tumor area plus margin of 15 Gy in fractions of 0.75 Gy. The total tumor dose was 55 Gy in 20 fractions in 4 weeks. Toxicity was scored according to EORTC/RTOG toxicity criteria.
  
  
  RESULTS
  The feasibility of the treatment was good. Severe acute toxicity >/=G3 was observed in seven patients (14%). Severe late toxicity >/=G3 was observed in six patients (13%). Thirty-seven patients (74%) showed a complete and five (10 %) a partial remission after treatment. The actuarial 3-year freedom of local progression was 55%.
  
  
  CONCLUSIONS
  In external radiotherapy for muscle invasive bladder cancer a concomitant boost technique coupling a partial bladder boost with shortening of the overall treatment time provides a high probability of local control with acceptable toxicity.
authors.affiliation: Department of Radiotherapy, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands.
authors.forename: Floris J
authors.initials: FJ
authors.lastname: Pos
authors.forename: Geertjan
authors.initials: G
authors.lastname: van Tienhoven
authors.forename: Maarten C C M
authors.initials: MC
authors.lastname: Hulshof
authors.forename: Kees
authors.initials: K
authors.lastname: Koedooder
authors.forename: Dionisio
authors.initials: D
authors.lastname: González González
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D007420:Intestine, Large / Q000528:radiation effects; D007421:Intestine, Small / Q000528:radiation effects; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D015996:Survival Rate; D013997:Time Factors; D001743:Urinary Bladder / Q000528:radiation effects; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*