Conservative treatment of bladder carcinoma by partial cystectomy and interstitial iridium 192

Journal Article · Thu Dec 01 04:00:00 EST 1988 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(88)90227-1· OSTI ID:6609449

Mazeron, J J; Crook, J; Chopin, D; Abbou, C C; Le Bourgeois, J P; Auvert, J; Pierquin, B

From 1971 to 1984, 85 patients with bladder carcinoma were treated conservatively at the Henri Mondor Hospital by a combination of short course of pre-operative external pelvic irradiation, iliac node dissection, partial cystectomy, and iridium 192 implantation. There were 79 transitional cell carcinomas (G1: 12, G2: 25, G3: 36, Gx: 6) and 6 squamous cell carcinomas. By clinical stage, based on endoscopic resection, there were 43 T1, 30 T2, 5 T3, and 7 Tx. After partial cystectomy the pathologic stage distribution was: 41 pT1, 31 pT2, and 13 pT3. Crude disease-free survival at 5 years is 72% for T1 tumors and 55% for T2, but overall only 16% of patients died of bladder carcinoma. Local failures were seen in 11.5% of T1 and 0% of T2 tumors, and second bladder tumors developed at a distance from the treated site in 11.5% of T1 and 7% of T2. There is a non significant trend for intravesical recurrences (both local failures and second tumors) to occur more frequently for G1 tumors (25%) than for G2 (16%) or G3 (7%). At 5 years 95% of disease-free survivors have a functioning bladder. Regional or distant metastases occurred in 54% of patients with pT3 tumors and 10% of those with pT1 or pT2; within each stage there was no apparent influence of grade on metastatic risk. The four patients with histologically positive iliac nodes received additional post-operative external pelvic irradiation; three died of metastases and one is disease free at 10 years. No abdominal scar recurrences were seen. Late complications occurred in 6% of the population. For T1 tumors we suggest modification of the described protocol, eliminating the pre-operative irradiation and the lymph node dissection. If there is no doubt as to the pathologic stage after complete endoscopic resection, iridium 192 implantation delivering a dose of 60 Gy, without partial cystectomy, may be sufficient management.

• Research Organization: Hospital Henri Mondor, Creteil (France)
• OSTI ID: 6609449
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 15:6; ISSN IOBPD
• Country of Publication: United States
• Language: English

Related Subjects

550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BETA-PLUS DECAY RADIOISOTOPES
BLADDER
BODY
CARCINOMAS
DAYS LIVING RADIOISOTOPES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
HEAVY NUCLEI
IMPLANTS
INTERNAL CONVERSION RADIOISOTOPES
IRIDIUM 192
IRIDIUM ISOTOPES
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
MINUTES LIVING RADIOISOTOPES
NEOPLASMS
NUCLEAR MEDICINE
NUCLEI
ODD-ODD NUCLEI
ORGANS
PATIENTS
RADIATION SOURCE IMPLANTS
RADIATION SOURCES
RADIOISOTOPES
RADIOLOGY
RADIOTHERAPY
SURVIVAL CURVES
THERAPY
URINARY TRACT
YEARS LIVING RADIOISOTOPES