title: Evaluation of acute toxicity and symptoms palliation in a hypofractionated weekly schedule of external radiotherapy for elderly patients with muscular invasive bladder cancer.
abstract: OBJECTIVE
  To evaluate acute toxicity and symptoms palliation of a weekly hypofractionated 3DCRT schedule as radical treatment in elderly patients with organ confined bladder cancer cT1-2N0.
  
  
  METHODS
  Between February 2005 and June 2011, 58 prospectively selected patients diagnosed with organ confined bladder cancer were treated with external 3DCRT (4-field arrangement). All candidates were medically inoperable, with poor performance status, and with age ranged from 75 to 88 years (median 78). A dose of 36 Gy in 6 weekly fractions was prescribed. The primary study endpoints were the evaluation of haematuria, dysuria, frequency and pain palliation as well as the acute toxicity according to the RTOG/EORTC scale: an assessment was performed at baseline, during and 3 months after radiotherapy, while the maximum reported score was taken into account.
  
  
  RESULTS
  The gastrointestinal acute toxicities were 13/58 (22.4%) and 5/58 (5.6%), for grade I and II respectively. The genitourinary acute toxicities were 19/58 (32.7%) and 10/58 (17.2%), for grade I and II respectively. In terms of clinical outcome, 55/58 patients (94.8%) reported palliation of haematuria, while 19 out of 58 reported no change in frequency and dysuria. All patients reported significant improvement (P < 0.01) for pain, concerning the visual analogue score before and after radiotherapy. The median progression free survival was 14 months.
  
  
  CONCLUSIONS
  The incidence of patient-reported acute toxicity following weekly hypofractionated external 3DCRT is low while the symptom palliation compares very favorably with other reported outcomes.
authors.affiliation: Radiotherapy Unit, 2nd Radiology Department, Athens, Greece. vkouloul@ece.ntua.gr
authors.forename: Vassilis
authors.initials: V
authors.lastname: Kouloulias
authors.forename: Maria
authors.initials: M
authors.lastname: Tolia
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kolliarakis
authors.forename: Argyris
authors.initials: A
authors.lastname: Siatelis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kelekis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D010147:Pain Measurement; D011829:Radiation Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects*; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000532:radiotherapy*