Ultra hypofractionated RT safe, effective for older patients with invasive bladder cancer

For older patients with invasive bladder cancer who are unfit for radical treatment, they may opt for weekly ultra hypofractionated intensity modulated radiotherapy (RT) with image guidance and bladder training, which is found to be an effective, safe, and well-tolerated regimen, suggests a study.

The authors performed a retrospective analysis on a cohort of patients with muscle invasive bladder cancer deemed not fit for chemoradiation therapy and thus treated with six weekly doses of 6 Gy using intensity modulated RT to determine the efficacy, safety, and tolerability of this regimen. They also calculated Charlson comorbidity retrospectively.

Local control and toxicity were assessed using the common terminology criteria via cystoscopy and computed tomography. Finally, the Kaplan-Meier method was applied to estimate survival outcomes.

Twenty-two patients (median age 84 years, range 70–96 years) met the inclusion criteria of the study, with a median comorbidity index of 6±1.5 standard deviation. Of the participants, 19 (90 percent) received the full 36 Gy dose.

Over a median follow-up of 10±7 months (range 6–27 months), 16 of 19 evaluable patients (84 percent) achieved local control in the bladder. Overall survival at 1 year was 62.5 percent. One patient had a retroperitoneal nodal recurrence, and three developed distant metastasis.

In addition, one (4.5 percent) and four (18 percent) patients experienced grade 3 genitourinary and gastrointestinal toxicity, respectively.