title: Radiation therapy outcomes in muscle invasive urinary bladder cancer: A single institution experience.
abstract: BACKGROUND
  To audit the survival outcomes and loco-regional control in muscle invasive urinary bladder cancer patients treated with external beam radiation therapy (RT).
  
  
  METHODS
  From November 2008 through December 2011, 50 consecutively diagnosed muscle invasive urinary bladder carcinoma (T2-4a N0-2, M0) patients were included in this retrospective study. All these patients received external beam RT to a median dose of 60 Gy (range 30-66 Gy), and were not suitable for radical surgery due to patients' preference or medical comorbidities. A stepwise procedure using proportional hazard regression was used to identify prognostic factors with respect to survival.
  
  
  RESULTS
  Completion trans-urethral resection of bladder tumor was done in 38 (76%) patients of the cohort and 47 (94%) had transitional cell carcinoma on histopathology. Clinical stage T2 was diagnosed in 40 (80%) patients. The median follow-up for the entire cohort was 14 ± 8.9 months (range 1-36 months). In conclusion, 24 patients (48%) were free of disease, 5 patients (10%) had residual disease, and 13 patients (26%) had died of disease. Two-year and 3 year overall survival of intact bladder for the entire cohort was 58% and 43.6%, respectively. Cox regression modeling strongly suggested clinical stage (P = 0.01) and RT dose (P = 0.001) as being predictors for overall survival.
  
  
  CONCLUSIONS
  RT shows reliable outcomes and excellent compliance in this advanced disease. Prescribing a higher RT dose could potentially correlate to better intact bladder control rates while maintaining good quality of life in selected patients.
authors.forename: M S
authors.initials: MS
authors.lastname: Tiwana
authors.affiliation: Department of Radiation Oncology, STM Cancer Research Institute, Himalayan Institute Hospital Trust, Swami Ram Nagar, Jolly Grant, Dehradun, India.
authors.forename: L H
authors.initials: LH
authors.lastname: Ni
authors.forename: S
authors.initials: S
authors.lastname: Saini
authors.forename: S K
authors.initials: SK
authors.lastname: Verma
authors.forename: D
authors.initials: D
authors.lastname: Doddamani
authors.forename: N
authors.initials: N
authors.lastname: Jain
authors.forename: M
authors.initials: M
authors.lastname: Biswas
authors.forename: Meenu
authors.initials: M
authors.lastname: Gupta
authors.forename: Madhur
authors.initials: M
authors.lastname: Gupta
authors.forename: M
authors.initials: M
authors.lastname: Saini
authors.forename: N
authors.initials: N
authors.lastname: Chauhan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*