skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Clinical Outcomes of Image Guided Adaptive Hypofractionated Weekly Radiation Therapy for Bladder Cancer in Patients Unsuitable for Radical Treatment

Abstract

Purpose and Objectives: We report on the clinical outcomes of a phase 2 study assessing image guided hypofractionated weekly radiation therapy in bladder cancer patients unsuitable for radical treatment. Methods and Materials: Fifty-five patients with T2-T4aNx-2M0-1 bladder cancer not suitable for cystectomy or daily radiation therapy treatment were recruited. A “plan of the day” radiation therapy approach was used, treating the whole (empty) bladder to 36 Gy in 6 weekly fractions. Acute toxicity was assessed weekly during radiation therapy, at 6 and 12 weeks using the Common Terminology Criteria for Adverse Events version 3.0. Late toxicity was assessed at 6 months and 12 months using Radiation Therapy Oncology Group grading. Cystoscopy was used to assess local control at 3 months. Cumulative incidence function was used to determine local progression at 1 at 2 years. Death without local progression was treated as a competing risk. Overall survival was estimated using the Kaplan-Meier method. Results: Median age was 86 years (range, 68-97 years). Eighty-seven percent of patients completed their prescribed course of radiation therapy. Genitourinary and gastrointestinal grade 3 acute toxicity was seen in 18% (10/55) and 4% (2/55) of patients, respectively. No grade 4 genitourinary or gastrointestinal toxicity was seen. Grade ≥3 late toxicity (any) at 6 and 12 monthsmore » was seen in 6.5% (2/31) and 4.3% (1/23) of patients, respectively. Local control after radiation therapy was 92% of assessed patients (60% total population). Cumulative incidence of local progression at 1 year and 2 years for all patients was 7% (95% confidence interval [CI] 2%-17%) and 17% (95% CI 8%-29%), respectively. Overall survival at 1 year was 63% (95% CI 48%-74%). Conclusion: Hypofractionated radiation therapy delivered weekly with a plan of the day approach offers good local control with acceptable toxicity in a patient population not suitable for radical bladder treatment.« less

Authors:
 [1];  [2]; ;  [3]; ; ;  [1];  [2];  [3]; ;  [4];  [3]; ; ; ;  [1];  [2]
  1. The Institute of Cancer Research, London (United Kingdom)
  2. (United Kingdom)
  3. The Royal Marsden NHS Foundation Trust, Sutton, Surrey (United Kingdom)
  4. The Royal Marsden NHS Foundation Trust, London (United Kingdom)
Publication Date:
OSTI Identifier:
22649914
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 98; Journal Issue: 1; Other Information: Copyright (c) 2017 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BLADDER; GY RANGE 10-100; IMAGES; NEOPLASMS; PATIENTS; RADIATION HAZARDS; RADICALS; RADIOTHERAPY; TOXICITY

Citation Formats

Hafeez, Shaista, E-mail: shaista.hafeez@icr.ac.uk, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, McDonald, Fiona, Lalondrelle, Susan, McNair, Helen, Warren-Oseni, Karole, Jones, Kelly, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, Harris, Victoria, Taylor, Helen, Khoo, Vincent, Thomas, Karen, Hansen, Vibeke, Dearnaley, David, Horwich, Alan, Huddart, Robert, and The Royal Marsden NHS Foundation Trust, Sutton, Surrey. Clinical Outcomes of Image Guided Adaptive Hypofractionated Weekly Radiation Therapy for Bladder Cancer in Patients Unsuitable for Radical Treatment. United States: N. p., 2017. Web. doi:10.1016/J.IJROBP.2017.01.239.
Hafeez, Shaista, E-mail: shaista.hafeez@icr.ac.uk, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, McDonald, Fiona, Lalondrelle, Susan, McNair, Helen, Warren-Oseni, Karole, Jones, Kelly, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, Harris, Victoria, Taylor, Helen, Khoo, Vincent, Thomas, Karen, Hansen, Vibeke, Dearnaley, David, Horwich, Alan, Huddart, Robert, & The Royal Marsden NHS Foundation Trust, Sutton, Surrey. Clinical Outcomes of Image Guided Adaptive Hypofractionated Weekly Radiation Therapy for Bladder Cancer in Patients Unsuitable for Radical Treatment. United States. doi:10.1016/J.IJROBP.2017.01.239.
Hafeez, Shaista, E-mail: shaista.hafeez@icr.ac.uk, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, McDonald, Fiona, Lalondrelle, Susan, McNair, Helen, Warren-Oseni, Karole, Jones, Kelly, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, Harris, Victoria, Taylor, Helen, Khoo, Vincent, Thomas, Karen, Hansen, Vibeke, Dearnaley, David, Horwich, Alan, Huddart, Robert, and The Royal Marsden NHS Foundation Trust, Sutton, Surrey. Mon . "Clinical Outcomes of Image Guided Adaptive Hypofractionated Weekly Radiation Therapy for Bladder Cancer in Patients Unsuitable for Radical Treatment". United States. doi:10.1016/J.IJROBP.2017.01.239.
@article{osti_22649914,
title = {Clinical Outcomes of Image Guided Adaptive Hypofractionated Weekly Radiation Therapy for Bladder Cancer in Patients Unsuitable for Radical Treatment},
author = {Hafeez, Shaista, E-mail: shaista.hafeez@icr.ac.uk and The Royal Marsden NHS Foundation Trust, Sutton, Surrey and McDonald, Fiona and Lalondrelle, Susan and McNair, Helen and Warren-Oseni, Karole and Jones, Kelly and The Royal Marsden NHS Foundation Trust, Sutton, Surrey and Harris, Victoria and Taylor, Helen and Khoo, Vincent and Thomas, Karen and Hansen, Vibeke and Dearnaley, David and Horwich, Alan and Huddart, Robert and The Royal Marsden NHS Foundation Trust, Sutton, Surrey},
abstractNote = {Purpose and Objectives: We report on the clinical outcomes of a phase 2 study assessing image guided hypofractionated weekly radiation therapy in bladder cancer patients unsuitable for radical treatment. Methods and Materials: Fifty-five patients with T2-T4aNx-2M0-1 bladder cancer not suitable for cystectomy or daily radiation therapy treatment were recruited. A “plan of the day” radiation therapy approach was used, treating the whole (empty) bladder to 36 Gy in 6 weekly fractions. Acute toxicity was assessed weekly during radiation therapy, at 6 and 12 weeks using the Common Terminology Criteria for Adverse Events version 3.0. Late toxicity was assessed at 6 months and 12 months using Radiation Therapy Oncology Group grading. Cystoscopy was used to assess local control at 3 months. Cumulative incidence function was used to determine local progression at 1 at 2 years. Death without local progression was treated as a competing risk. Overall survival was estimated using the Kaplan-Meier method. Results: Median age was 86 years (range, 68-97 years). Eighty-seven percent of patients completed their prescribed course of radiation therapy. Genitourinary and gastrointestinal grade 3 acute toxicity was seen in 18% (10/55) and 4% (2/55) of patients, respectively. No grade 4 genitourinary or gastrointestinal toxicity was seen. Grade ≥3 late toxicity (any) at 6 and 12 months was seen in 6.5% (2/31) and 4.3% (1/23) of patients, respectively. Local control after radiation therapy was 92% of assessed patients (60% total population). Cumulative incidence of local progression at 1 year and 2 years for all patients was 7% (95% confidence interval [CI] 2%-17%) and 17% (95% CI 8%-29%), respectively. Overall survival at 1 year was 63% (95% CI 48%-74%). Conclusion: Hypofractionated radiation therapy delivered weekly with a plan of the day approach offers good local control with acceptable toxicity in a patient population not suitable for radical bladder treatment.},
doi = {10.1016/J.IJROBP.2017.01.239},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 98,
place = {United States},
year = {Mon May 01 00:00:00 EDT 2017},
month = {Mon May 01 00:00:00 EDT 2017}
}