Radiation therapy in urinary cancer: state of the art and perspective.
Invasive urinary tumours are relatively rare, and their treatment may cause important changes in urinary, sexual and social functions. A systematic review of external radiation therapy studies in urinary cancers was performed. This synthesis of the literature is based on data from meta-analyses, randomised and prospective trials and retrospective studies. There are few controlled clinical trials using adjuvant or radical radiotherapy with or without chemotherapy in cancer of the kidney, ureter and urethra. There are several reports on multimodality treatment in invasive bladder cancer: intravesical surgery and neoadjuvant chemotherapy to radiotherapy or concomitant radiochemotherapy with organ preservation. The conclusions reached for renal cancer are controversial, and data on cancers of the urethra and ureter are few and inconclusive. Sufficient data now exist in the literature to demonstrate that conservative management with organ preservation is a valuable alternative to radical cystectomy, the traditional gold standard, in invasive bladder cancer.
Troiano
M
M
Department of Radiation Oncology, Scientific Institute Hospital Casa Sollievo della Sofferenza, and University of Foggia, Department of Radiology, San Giovanni Rotondo, 71013, Foggia, Italy.
Corsa
P
P
Raguso
A
A
Cossa
S
S
Piombino
M
M
Guglielmi
G
G
Parisi
S
S
D001918:Brachytherapy; D003131:Combined Modality Therapy; D018849:Controlled Clinical Trials as Topic; D015653:Cystectomy; D003627:Data Interpretation, Statistical; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D015201:Meta-Analysis as Topic; D009367:Neoplasm Staging; D009392:Nephrectomy; D009926:Organ Preservation; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014513:Ureter / Q000473:pathology; D014516:Ureteral Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D014521:Urethra / Q000473:pathology; D014523:Urethral Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D014571:Urologic Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery