title: Intensity modulated radiotherapy for elderly bladder cancer patients.
abstract: BACKGROUND
  To review our experience and evaluate treatment planning using intensity-modulated radiotherapy (IMRT) and helical tomotherapy (HT) for the treatment of elderly patients with bladder cancer.
  
  
  METHODS
  From November 2006 through November 2009, we enrolled 19 elderly patients with histologically confirmed bladder cancer, 9 in the IMRT and 10 in the HT group. The patients received 64.8 Gy to the bladder with or without concurrent chemotherapy. Conventional 4-field "box" pelvic radiation therapy (2DRT) plans were generated for comparison.
  
  
  RESULTS
  The median patient age was 80 years old (range, 65-90 years old). The median survival was 21 months (5 to 26 months). The actuarial 2-year overall survival (OS) for the IMRT vs. the HT group was 26.3% vs .37.5%, respectively; the corresponding values for disease-free survival were 58.3% vs. 83.3%, respectively; for locoregional progression-free survival (LRPFS), the values were 87.5% vs. 83.3%, respectively; and for metastases-free survival, the values were 66.7% vs. 60.0%, respectively. The 2-year OS rates for T1, 2 vs. T3, 4 were 66.7% vs. 35.4%, respectively (p = 0.046). The 2-year OS rate was poor for those whose RT completion time greater than 8 weeks when compared with the RT completed within 8 wks (37.9% vs. 0%, p = 0.004).
  
  
  CONCLUSIONS
  IMRT and HT provide good LRPFS with tolerable toxicity for elderly patients with invasive bladder cancer. IMRT and HT dosimetry and organ sparing capability were superior to that of 2DRT, and HT provides better sparing ability than IMRT. The T category and the RT completion time influence OS rate.
authors.affiliation: Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: Chen-Hsi
authors.initials: CH
authors.lastname: Hsieh
authors.forename: Shiu-Dong
authors.initials: SD
authors.lastname: Chung
authors.forename: Pei-Hui
authors.initials: PH
authors.lastname: Chan
authors.forename: Siu-Kai
authors.initials: SK
authors.lastname: Lai
authors.forename: Hsiao-Chun
authors.initials: HC
authors.lastname: Chang
authors.forename: Chi-Huang
authors.initials: CH
authors.lastname: Hsiao
authors.forename: Le-Jung
authors.initials: LJ
authors.lastname: Wu
authors.forename: Ngot-Swan
authors.initials: NS
authors.lastname: Chong
authors.forename: Yu-Jen
authors.initials: YJ
authors.lastname: Chen
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Wang
authors.forename: Yen-Ping
authors.initials: YP
authors.lastname: Hsieh
authors.forename: Pei-Wei
authors.initials: PW
authors.lastname: Shueng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D011874:Radiometry; D011880:Radiotherapy Planning, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000532:radiotherapy*