Saving bladders with brachytherapy: implantation technique and results

“…The brachytherapy applied according to patient and tumor characteristics and dose data are presented in Table 1 and supplementary Table S1. More details about applied doses, dose rate and overall treatment times can be found in a number of separately published studies [16,[19][20][21][22].…”

Section: Ebrt and Brachytherapy: Administered Dosementioning

confidence: 99%

Brachytherapy after external beam radiotherapy and limited surgery preserves bladders for patients with solitary pT1–pT3 bladder tumors

et al. 2012

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“…While the long‐term results of salvage cystectomy after EBRT have been reported more often, only a few series include such results after IRT. To our knowledge, there is only one report [8] of 13 patients, of whom six remained free of disease following salvage cystectomy after the failure of IRT. Moreover, little is known about the surgical and functional results after orthotopic urinary diversions subsequent to radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Salvage cystectomy after failure of interstitial radiotherapy and external beam radiotherapy for bladder cancer

Nieuwenhuijzen¹,

Horenblas²,

Meinhardt³

et al. 2004

BJU International

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OBJECTIVE To evaluate the long‐term results of salvage cystectomy after interstitial radiotherapy (IRT) and external beam radiotherapy (EBRT) for transitional cell carcinoma, and to assess the morbidity and functional results of the different urinary diversions used. PATIENTS AND METHODS The records of 27 patients treated with salvage cystectomy in one institution between 1988 and 2003 were retrospectively analysed. RESULTS Salvage cystectomy was used after failure of IRT in 14 or EBRT in 13 patients, with a 3‐ and 5‐year survival probability of 46% (95% confidence interval 26–65) and 33 (11–54)%. The 5‐year overall survival after cystectomy was 54% after IRT and 14% after EBRT (P = 0.12). Tumour category, response to radiation, American Society of Anesthesiology score, and complete tumour resection had a significant influence on survival. Five of seven patients with incomplete resection died because of local disease, with a median survival of 5 months. There was clinical understaging after radiotherapy in 41% of patients. Nine patients had an orthotopic neobladder, with complete day‐ and night‐time continence in eight and four, respectively. All patients but one had good voiding function. There were early complications in two and late complications in six patients (for Bricker, seven of 14 and none; for Indiana, none of four and two of four). The duration of hospitalization was not influenced by the type of diversion. Erectile function was maintained in four of six patients after a sexuality‐preserving cystectomy and neobladder. CONCLUSIONS Salvage cystectomy can be performed with acceptable morbidity using any type of urinary diversion. Understaging after radiotherapy is common, but preoperative selection needs improving. A very significant factor for an adverse outcome and death from local tumour recurrence was incomplete resection, suggesting that salvage cystectomy should only be attempted if complete resection is probable.

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“…Based on this approach, bladder preservation with CMT‐BT could also be considered with the option of a salvage cystectomy if required. The average LR rate across all of studies was 14% (0–32%), although some studies did report higher LR rates (>30%) [21,26,27]. For example, in the study by van der Steen‐Banasik et al [26] there was a 33% LR rate within the bladder, of which 11.8% were recurrences within the previous BT field.…”

Section: Discussionmentioning

confidence: 99%

Overall survival, disease‐specific survival and local recurrence outcomes in patients with muscle‐invasive bladder cancer treated with external beam radiotherapy and brachytherapy: a systematic review

et al. 2020

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Registration: PROSPERO registration number is: CRD42019129349. ConclusionBrachytherapy as part of CMT for MIBC is not a standard technique. It is an effective treatment in experienced centres for a selected patient population who wish to preserve their bladder. In such patients, CMT-BT is well tolerated with an acceptable safety profile.Keywords muscle-invasive bladder cancer, interstitial brachytherapy, external beam radiotherapy, organ preservation

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Saving bladders with brachytherapy: implantation technique and results

Cited by 39 publications

References 28 publications

Brachytherapy after external beam radiotherapy and limited surgery preserves bladders for patients with solitary pT1–pT3 bladder tumors

Brachytherapy after external beam radiotherapy and limited surgery preserves bladders for patients with solitary pT1–pT3 bladder tumors

Salvage cystectomy after failure of interstitial radiotherapy and external beam radiotherapy for bladder cancer

Overall survival, disease‐specific survival and local recurrence outcomes in patients with muscle‐invasive bladder cancer treated with external beam radiotherapy and brachytherapy: a systematic review

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