Urinary bladder preservation for muscle-invasive bladder cancer: a survey among radiation oncologists of Lombardy, Italy.
OBJECTIVE
Bladder preservation is a treatment option in muscle-invasive bladder carcinoma. The most investigated approach is a trimodality schedule including maximum transurethral resection of bladder tumor (TURBT) followed by chemoradiotherapy. Our aim was to evaluate the use of bladder preservation by radiation oncologists of the Lombardy region in Italy.


METHODS
A survey with 13 items regarding data of 2012 was sent to all 32 radiotherapy centers within the collaboration between the Lombardy Oncological Network and the Lombardy Section of the Italian Society of Oncological Radiotherapy.


RESULTS
Thirteen centers (41%) answered the survey; the presented data come from 11 active centers. In these centers, 11,748 patients were treated with external-beam radiotherapy in 2012, 100 of whom having bladder cancer (0.9%). 74/100 patients received radiotherapy as palliative treatment for T, N or M lesions. A further 9 and 5 patients received radiotherapy for oligometastatic disease (ablative doses to small volumes) and postoperatively, respectively. Bladder preservation was performed in 12 cases and included trimodality and other strategies (mainly TURBT followed by radiotherapy). A multidisciplinary urology tumor board met regularly in 5 of 11 centers. All responders declared their interest in the Lombardy multicenter collaboration on bladder preservation.


CONCLUSIONS
Our survey showed that bladder preservation is rarely used in Lombardy despite the availability of the latest radiotherapy technologies and the presence of an urology tumor board in half of the centers. The initiative of multicenter and multidisciplinary collaboration was undertaken to prepare the platform for bladder preservation as a treatment option in selected patients.
European Institute of Oncology, Milan - Italy.
Barbara Alicja
BA
Jereczek-Fossa
Renzo
R
Colombo
Tiziana
T
Magnani
Cristiana
C
Fodor
Marianna Alessandra
MA
Gerardi
Paolo
P
Antognoni
Lucia
L
Barsacchi
Nice
N
Bedini
Stefano
S
Bracelli
Alberto
A
Buffoli
Emanuela
E
Cagna
Gianpiero
G
Catalano
Stefania
S
Gottardo
Corrado
C
Italia
Giovanni Battista
GB
Ivaldi
Stefano
S
Masciullo
Anna
A
Merlotti
Enrico
E
Sarti
Marta
M
Scorsetti
Flavia
F
Serafini
Mariasole
M
Toninelli
Elisabetta
E
Vitali
Riccardo
R
Valdagni
Elisa
E
Villa
Dario
D
Zerini
Ottavio
O
De Cobelli
Roberto
R
Orecchia
D000328:Adult; D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007558:Italy; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D059351:Organ Sparing Treatments / Q000379:methods*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D018787:Radiation Oncology; D011795:Surveys and Questionnaires; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D000078329:Workforce