Curative radiation therapy for very elderly bladder cancer patients with localized disease
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M. Bonet [1] ; T. Bonfill [2] ; M. Nuñez [3] ; L. De Verdonces [2] ; E. Mur [3] ; E. Gallardo [2] ; L. Fernandez-Morales [2] ; A. Aguilar [3] ; J. Prats [2] ; M. Arenas [1]
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[1] Hospital Universitari Sant Joan de Reus
Hospital Universitari Sant Joan de Reus
Reus, España
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[2] Hospital Universitari Parc Taulí, España
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[3] Consorci Sanitari de Terrassa, España
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- Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 20, Nº. 7 (July 2018), 2018, págs. 899-905
- Idioma: inglés
- Texto completo no disponible (Saber más ...)
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Resumen
Purpose To report the outcomes of a cohort of very elderly muscle-invasive bladder cancer (MIBC) patients treated with contemporary 3D-conformal radiation therapy (3D-CRT) with or without concurrent chemotherapy, after transurethral resection of bladder tumor (TURBT).
Methods From February 2010 to January 2014, a total of 41 patients older than 75 years, with T2-3 N0-1 high-grade MIBC, a Karnofsky index (KI) of at least 90% and/or a Barthel scale score of at least 95, were treated with TURBT followed by radiotherapy (RT) with or without chemotherapy, and were prospectively followed-up.
Results The mean age of patients was 82 years (range 76–88). Median follow-up was 47 months for surviving patients. Mean Charlson Comorbidity Index (CCI) score was 5 points. 28 patients (68.29%) were T2N0. All received 3D-CRT to a mean dose of 60 Gy (range 48.6–66 Gy), and chemotherapy was delivered to 34 patients (83%). Cause-specific survival (CSS) was 86 and 78.8% at 1 and 5 years, respectively. Patients achieving a complete response lived longer (48 vs 14 m, p = 0.036) than those with a progressive disease, who were more likely to die from cancer than from other causes (HR 3.865, IC95% 1.562–9.562). Dead patients had a longest treatment time (mean 56.78 vs 48.91 days, p = 0.019) than survivors.
Conclusion RT with contemporary 3D-CRT techniques after TURBT for MIBC in elderly patients is feasible and well-tolerated. Achieving a maximal response and shortening the total radiation treatment time may improve outcomes and quality of life.
