title: Patterns of practice in the radiation therapy for bladder cancer: survey of the Japanese Radiation Oncology Study Group (JROSG).
abstract: OBJECTIVE
  To retrospectively analyze the clinical outcomes of radiation therapy with or without chemotherapy for bladder cancer in Japan.
  
  
  METHODS
  A questionnaire-based survey of patients with pathologically proven bladder cancer treated by definitive radiation therapy between 2002 and 2006 was conducted by the Japanese Radiation Oncology Study Group, and the clinical records of 159 patients were collected from 17 institutions. Concurrent intra-arterial chemoradiotherapy and concurrent systemic chemoradiotherapy were administered in 51 and 33 patients, respectively.
  
  
  RESULTS
  The 5-year overall survival and bladder preservation rates were 48 and 39%, respectively. Eighty-nine (56%) patients developed recurrence (bladder, 48; regional lymph nodes, 4; distant sites, 41). The results of multivariate analysis revealed that adoption of chemotherapy was the only significant prognostic factor for overall survival (relative risk = 0.615 [95% confidence interval: 0.439-0.862], P = 0.005). The type of chemotherapy administered did not significantly affect the local control or overall survival rates. The actuarial 5-year overall survival rates and bladder preservation in the radiation therapy combined with intra-arterial chemotherapy group were 64 and 58%, respectively, and the corresponding rates in the radiation therapy combined with systemic chemotherapy group were 67 and 42%, respectively.
  
  
  CONCLUSIONS
  The results of this survey revealed the current status of practice of radiation therapy for bladder cancer in Japan. A multi-institutional prospective study is needed based on the results of this study to determine the optimal radiotherapeutic approach, including the need for concurrent chemotherapy and the appropriate chemotherapy regimen for invasive bladder cancer.
authors.affiliation: Department of Radiology, Nihon University School of Medicine, Tokyo maebayashi.toshiya@nihon-u.ac.jp.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Maebayashi
authors.affiliation: Department of Radiation Oncology, University of Tsukuba, Tsukuba.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ishikawa
authors.affiliation: Department of Radiology, National Hospital Organization Tokyo Medical Center, Tokyo.
authors.forename: Atsunori
authors.initials: A
authors.lastname: Yorozu
authors.affiliation: Department of Radiation Oncology, Gunma Prefectural Cancer Center, Ota.
authors.forename: Daisaku
authors.initials: D
authors.lastname: Yoshida
authors.affiliation: Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Katoh
authors.affiliation: Department of Radiation Oncology, Yamagata University Faculty of Medicine, Yamagata.
authors.forename: Kenji
authors.initials: K
authors.lastname: Nemoto
authors.affiliation: Department of Radiology, Toyohashi Municipal Hospital, Toyohashi.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Ishihara
authors.affiliation: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya.
authors.forename: Shinya
authors.initials: S
authors.lastname: Takemoto
authors.affiliation: Department of Radiology, Nihon University School of Medicine, Tokyo.
authors.forename: Naoya
authors.initials: N
authors.lastname: Ishibashi
authors.affiliation: Department of Heavy Particle Therapy and Radiation Oncology, Saga University, Saga.
authors.forename: Sunao
authors.initials: S
authors.lastname: Tokumaru
authors.affiliation: Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Akimoto
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D059351:Organ Sparing Treatments; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery
keywords: bladder cancer; intra-arterial chemotherapy; radiation therapy; systemic chemotherapy