Intensity modulated radiotherapy for elderly bladder cancer patients
1 Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan
2 Division of Urology, Far Eastern Memorial Hospital, Taipei, Taiwan
3 Division of Medical Oncology and Hematology, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan
4 Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan
5 Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
6 Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan
7 Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
8 Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan
9 School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
10 Department of Healthcare Administration, Asia University, Taichung, Taiwan
Radiation Oncology 2011, 6:75 doi:10.1186/1748-717X-6-75Published: 16 June 2011
To review our experience and evaluate treatment planning using intensity-modulated radiotherapy (IMRT) and helical tomotherapy (HT) for the treatment of elderly patients with bladder cancer.
From November 2006 through November 2009, we enrolled 19 elderly patients with histologically confirmed bladder cancer, 9 in the IMRT and 10 in the HT group. The patients received 64.8 Gy to the bladder with or without concurrent chemotherapy. Conventional 4-field "box" pelvic radiation therapy (2DRT) plans were generated for comparison.
The median patient age was 80 years old (range, 65-90 years old). The median survival was 21 months (5 to 26 months). The actuarial 2-year overall survival (OS) for the IMRT vs. the HT group was 26.3% vs .37.5%, respectively; the corresponding values for disease-free survival were 58.3% vs. 83.3%, respectively; for locoregional progression-free survival (LRPFS), the values were 87.5% vs. 83.3%, respectively; and for metastases-free survival, the values were 66.7% vs. 60.0%, respectively. The 2-year OS rates for T1, 2 vs. T3, 4 were 66.7% vs. 35.4%, respectively (p = 0.046). The 2-year OS rate was poor for those whose RT completion time greater than 8 weeks when compared with the RT completed within 8 wks (37.9% vs. 0%, p = 0.004).
IMRT and HT provide good LRPFS with tolerable toxicity for elderly patients with invasive bladder cancer. IMRT and HT dosimetry and organ sparing capability were superior to that of 2DRT, and HT provides better sparing ability than IMRT. The T category and the RT completion time influence OS rate.