Skip to main content

Clinical Situations for the Role of Radiation Therapy in the Treatment of Bladder Cancer

  • Chapter
Bladder Cancer

Part of the book series: Current Clinical Urology ((CCU))

  • 144 Accesses

Abstract

The majority of bladder cancer patients present with superficial disease and are managed with conservative measures using transurethral resection with or without intravesical chemotherapy. Approximately 20–25% present with muscle invasive bladder cancer, that is potentially life threatening and requires radical treatment. Definitive radiation therapy (RT) has been used for muscle invasive bladder cancer since the early 1900s and there is evidence that patients can achieve durable local control and maintain a functional bladder without a compromise in survival. However, the standard North American approach to the management of bladder cancer not suitable for conservative measures is radical cystectomy (1). In the past few decades, radical radiation therapy has been used in patients who either refused or were not suitable for radical cystectomy. Therefore, there is a limited amount of information on the precise role that radiation therapy plays in the management of bladder cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Scher H, Shipley W, Herr W. Cancer of the Bladder. In: Cancer, Principle and Practice (De Vita JV, Hellman S, Rosenberg S, eds.). 5th ed. Lippincott-Raven, Philadelphia, PA, 1997, pp. 1300–1322.

    Google Scholar 

  2. Gospodarowicz MK, Quilty PM, Scalliet P, Tsujii H, Fossa SD, Horenblas S, et al. The place of radiation therapy as definitive treatment of bladder cancer. Int J Urol 1995; 2 (41): 41–48.

    Article  PubMed  Google Scholar 

  3. Palou J, Sanchez-Martin FM, Rosales A, Salvador J, Algaba F, Vicente J. Intravesical bacille Calmette-Guerin in the treatment of carcinoma in situ or high-grade superficial bladder carcinoma after radiotherapy for bladder carcinoma. Br J Urol Int 1999; 83 (4): 429–431.

    Article  CAS  Google Scholar 

  4. Pisters LL, Tykochinsky G, Wajsman Z. Intravesical bacillus Calmette-Guerin or mitomycin C in the treatment of carcinoma in situ of the bladder following prior pelvic radiation therapy. J Urol 1991; 146 (6): 1514–1517.

    CAS  PubMed  Google Scholar 

  5. Zietman AL, Shipley WU, Heney NM, Althausen AF. The case for radiotherapy with or without chemotherapy in high-risk superficial and muscle-invading bladder cancer. Semin Urol Oncol 1997; 15 (3): 161–168.

    CAS  PubMed  Google Scholar 

  6. Shipley WU, Zietman AL, Kaufman DS, Althausen AF, Heney NM. Invasive bladder cancer: treatment strategies using transurethral surgery, chemotherapy and radiation therapy with selection for bladder conservation. Int J Radiat Oncol Biol Phys 1997; 39 (4): 937–943.

    Article  CAS  PubMed  Google Scholar 

  7. Gospodarowicz MK, Rider WD, Keen CW, Connolly JG, Jewett MAS, Cummings BJ, et al. Bladder cancer: long term follow-up results of patients treated with radical radiation. Clin Oncol 1991; 3: 155–161.

    Article  CAS  Google Scholar 

  8. Bloom Hi, Hendry WF, Wallace DM, Skeet RG. Treatment of T3 bladder cancer: controlled trial of pre-operative radiotherapy and radical cystectomy versus radical radiotherapy. Br J Urol 1982; 54 (2): 136–151.

    Article  Google Scholar 

  9. Anderstrom C, Johansson S, Nilsson S, et al. A prospective randomised study of preoperative irradiation with cystectomy or cystectomy alone for invasive bladder carcinoma. Eur Urol 1931983; 9: 142–147.

    Google Scholar 

  10. Huncharek M, Muscat J, Geschwind JF. Planned preoperative radiation therapy in muscle invasive bladder cancer; results of a meta-analysis. Anticancer Res 1998; 18 (3B): 1931–1934.

    CAS  PubMed  Google Scholar 

  11. Spera JA, Whittington R, Littman P, Solin LJ, Wein AJ. A comparison of preoperative radiotherapy regimens for bladder carcinoma: The University of Pennsylvania experience. Cancer 1988; 61: 255–262.

    CAS  Google Scholar 

  12. Smith J, Crawford E, Paradelo J, Blumenstein B, Herschman B, Grossman B, et al. Treatment of advanced bladder cancer with combined preoperative irradiation and radical cystectomy versus radical cystectomy alone: a Phase III Intergroup study. J Urol 1997; 157: 805–808.

    Article  PubMed  Google Scholar 

  13. Duncan W, Quilty PM. The results of a series of 963 patients with transitional cell carcinoma of the urinary bladder primarily treated by radical megavoltage x-ray therapy. Radiother Oncol 1986; 7: 299–310.

    Article  CAS  PubMed  Google Scholar 

  14. Gospodarowicz MK, Hawkins NV, Rawlings GA, Connolly JG, Jewett MAS, Thomas GM, et al. Radical radiotherapy for the muscle invasive transitional cell carcinoma of the bladder: Failure analysis. J Urol 1989; 142: 1448–1454.

    CAS  PubMed  Google Scholar 

  15. Greven KM, Solin LJ, Hanks GE. Prognostic factors in patients with bladder carcinoma treated with definitive irradiation. Cancer 1990; 65: 908–912.

    Article  CAS  PubMed  Google Scholar 

  16. Fung CY, Shipley WU, Young RH, Griffin PP, Convery KM, Kaufman DS, et al. Prognostic factors in invasive bladder carcinoma in a prospective trial of preoperative adjuvant chemotherapy and radiotherapy [see comments]. J Clin Oncol 1991; 9 (9): 1533–1542.

    CAS  PubMed  Google Scholar 

  17. Davidson SE, Symonds RP, Snee MP, Upadhyay S, Habeshaw T, Robertson AG. Assessment of factors influencing the outcome of radiotherapy for bladder cancer. Br J Urol 1990; 66 (3): 288–293.

    Article  CAS  PubMed  Google Scholar 

  18. Blandy JP, Jenkins BJ, Fowler CG, Caulfield M, Badenoch DF, England HR, et al. Radical radiotherapy and salvage cystectomy for T2/3 cancer of the bladder. Prog Clin Biol Res 1988; 260: 447–451.

    CAS  PubMed  Google Scholar 

  19. Jenkins BJ, Caulfield MJ, Fowler CG, Badenoch DF, Tiptaft RC, Paris AMI, et al. Reappraisal of the role of radical radiotherapy and salvage cystectomy in the treatment of invasive (T2/T3) bladder cancer. Br J Urol 1988; 62: 342–346.

    Article  Google Scholar 

  20. Jacobsen AB, Lunde S, Ous S, et al. T2/T3 bladder carcinomas treated with definitive radiotherapy with emphasis on flow cytometric DNA ploidy values. Int J Radiat Oncol Biol Phys 1989; 17: 923–929.

    Article  CAS  PubMed  Google Scholar 

  21. Fossa SD, Ous S, Knudsen OS. Radical irradiation of T2 and T3 bladder carcinoma. Acta Radiol Oncol 1985; 24 (6): 497–501.

    Article  CAS  PubMed  Google Scholar 

  22. Smaaland R, Akslen L, Tonder B, Mehus A, Lote K, Albrektsen G. Radical radiation treatment of invasive and locally advanced bladder cancer in elderly patients. Br J Urol 1991; 67: 61–69.

    Article  CAS  PubMed  Google Scholar 

  23. Vale JA, A’Hern RP, Liu K, Hendry WF, Whitfield HN, Plowman PN, et al. Predicting the outcome of radical radiotherapy for invasive bladder cancer. Eur Urol 1993; 24 (1): 48–51.

    CAS  PubMed  Google Scholar 

  24. Farah R, Chodak GW, Vogelzang NJ, Awan AM, Quiet CA, Moormeier J, et al. Curative radiotherapy following chemotherapy for invasive bladder carcinoma (a preliminary report). Int J Radiat Oncol Biol Phys 1991; 20 (3): 413–417.

    Article  CAS  PubMed  Google Scholar 

  25. Hall R. Neo-adjuvant CMV chemotherapy and cystectomy or radiotherapy in muscle invasive bladder cancer. First analysis of MRC/EORTC intercontinental trial. Proc Am Soc Clin Oncol 1996; 15: 244; #612.

    Google Scholar 

  26. Housset M, Maulard C, Chretien Y, Dufour B, Delanian S, Huart J, et al. Combined radiation and chemotherapy for invasive transitional-cell carcinoma of the bladder: a prospective study. J Clin Urol 1993; 11 (11): 2150–2157.

    CAS  Google Scholar 

  27. Jakse G, Frommhold H. Radiotherapy and chemotherapy in locally advanced bladder cancer. Eur Urol 1985; 14 (Suppl 1): 45.

    Google Scholar 

  28. Raghavan D, Wallace M. Preemptive (neoadjuvant) chemotherapy: can analysis of eligibility criteria, prognostic factors, and tumor staging from different trials provide valid or useful comparisons? Semin Oncol 1990; 17 (5): 613–618.

    CAS  PubMed  Google Scholar 

  29. Russell KJ, Boileau MA, Higano C, Collins C, Russell AH, Koh W, et al. Combined 5-fluorouracil and irradiation for transitional cell carcinoma of the urinary bladder [see comments]. Int J Radiat Oncol Biol Phys 1990; 19 (3): 693–699.

    Article  CAS  PubMed  Google Scholar 

  30. Sauer R, Birkenhake S, Kuhn R, Wittekind C, Schrott KM, Martus P. Efficacy of radiochemotherapy with platin derivatives compared to radiotherapy alone in organ-sparing treatment of bladder cancer. Int J Radiat Oncol Biol Phys 1998; 40 (1): 121–127.

    Article  CAS  PubMed  Google Scholar 

  31. Shipley WU, Kaufman DS, Heney NM, Althausen AF, Zietman AL. An update of combined modality therapy for patients with muscle invading bladder cancer using selective bladder preservation or cystectomy. J Urol 1999; 162(2): 445–450; discussion 450–451.

    Google Scholar 

  32. Vogelzang NJ, Moormeier JA, Awan AM, Weichselbaum RR, Farah R, Straus FD, et al. Methotrexate, vinblastine, doxorubicin and cisplatin followed by radiotherapy or surgery for muscle invasive bladder cancer: the University of Chicago experience. J Urol 1993; 149 (4): 753–757.

    CAS  PubMed  Google Scholar 

  33. Shipley WU, Van der Schueren E, Kitigawa T, Gospodarowicz MK, Fromhold H, Magno L, et al. (eds). Guidelines for radiation therapy in clinical research on bladder cancer. Alan R. Liss, 1986.

    Google Scholar 

  34. Coppin C, Gospodarowicz M, James K, Tannock I, Zee B, Carson J, et al. The NCI-Canada trial of concurrent cisplatin and radiotherapy for muscle invasive bladder cancer. J Clin Oncol 1996; 14: 2901–2907.

    CAS  PubMed  Google Scholar 

  35. Eapen L, Stewart D, Crook J, Aitken S, Danjoux C, Rasuli P, et al. Intraarterial cisplatin and concurrent pelvic radiation in the management of muscle invasive bladder cancer. Int J Radiat Oncol Biol Phys 1992; 24 (Suppl 1): 211.

    Google Scholar 

  36. Eapen LDS, Danjoux C, Genest P, Futter N, Moors D, et al. Intraarterial cisplatin and concurrent radiation for locally advanced bladder cancer. J Clin Oncol 1989; 7 (2): 230–235.

    CAS  PubMed  Google Scholar 

  37. Tester W, Caplan R, Heaney J, Venner P, Whittington R, Byhardt R, et al. Neo-adjuvant combined modality program with selective organ preservation for invasive bladder cancer: results of Radiation Therapy Oncology Group phase II trial 8802. J Clin Oncol 1996; 14 (1): 119–126.

    CAS  PubMed  Google Scholar 

  38. Ghersi D, Stewart LA, Palmar MKB, et al. Neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscle-invasive bladder cancer: a randomised controlled trial. International collaboration of trialists. Lancet 1999; 354 (9178): 533–540.

    Article  Google Scholar 

  39. Naslund I, Nilsson B, Littbrand B. Hyperfractionated radiotherapy of bladder cancer. A ten-year follow-up of a randomised clinical trial. Acta Oncol 1994; 33 (4): 397–402.

    Article  CAS  PubMed  Google Scholar 

  40. Cole DJ, Durrant KR, Roberts JT, Dawes PJ, Yosef H, Hopewell JW. A pilot study of accelerated fractionation in the radiotherapy of invasive carcinoma of the bladder. Br J Radiol 1992; 65 (777): 792–798.

    Article  CAS  PubMed  Google Scholar 

  41. Horwich A, Dearnaley D, Huddart R, Graham J, Bessel E, Mason M, et al. A trial of accelerated fractionation in T2/3 bladder cancer. Eur J Cancer 1999; 35 (Suppl 4): 5342.

    Google Scholar 

  42. Moonen L, van der Voet H, Horenblas S, Bartelink H. A feasibility study of accelerated fractionation in radiotherapy of carcinoma of the urinary bladder. Int J Radiat Oncol Biol Phys 1997; 37 (3): 537–542.

    Article  CAS  PubMed  Google Scholar 

  43. Overgaard J. Clinical evaluation of nitroimidazoles as modifiers of hypoxia in solid tumors. Oncol Res 1994; 6 (10/11): 509–518.

    CAS  PubMed  Google Scholar 

  44. Hoskin PJ, Saunders MI, Phillips H, Cladd H, Powell ME, Goodchild K, et al. Carbogen and nicotinamide in the treatment of bladder cancer with radical radiotherapy. Br J Cancer 1997; 76 (2): 260–263.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  45. El-Wahidi G, Ghoneim MA, Saker H, Fouda MA. Preoperative radiotherapy of schistosomal bladder cancer. Proceedings from ECCO-10 Conference, Vienna, 1999.

    Google Scholar 

  46. Bochner BH, Figueroa AJ, Skinner EC, Lieskovsky G, Petrovich Z, Boyd SD, et al. Salvage radical cystoprostatectomy and orthotopic urinary diversion following radiation failure. J Urol 1998; 160 (1): 29–33.

    Article  CAS  PubMed  Google Scholar 

  47. Mannel RS, Manetta A, Buller RE, Braly PS, Walker JL, Archer JS. Use of ileocecal continent urinary reservoir in patients with previous pelvic irradiation. Gynecol Oncol 1995; 59 (3): 376–378.

    Article  CAS  PubMed  Google Scholar 

  48. Reisinger SA, Mohiuddin M, Mulholland SG. Combined pre-and postoperative adjuvant radiation therapy for bladder cancer-a ten year experience [see comments]. Int J Radiat Oncol Biol Phys 1992; 24 (3): 463–468.

    Article  CAS  PubMed  Google Scholar 

  49. Zaghloul MS, Awwad HK, Akoush HH, Omar S, Soliman O, et al. Postoperative radiotherapy of carcinoma in bilharzial bladder: improved disease free survival through improving local control. Int J Radiat Oncol Biol Phys 1992; 23(3): 511517.

    Google Scholar 

  50. Skinner DG, Tift JP, Kaufman JJ. High dose, short course preoperative radiation therapy and immediate single stage radical cystectomy with pelvic node dissection in the management of bladder cancer. J Urol 1982; 127 (4): 671–674.

    CAS  PubMed  Google Scholar 

  51. Kopelson G, Heaney JA. Postoperative radiation therapy for muscle-invading bladder carcinoma. J Surg Oncol 1983; 23 (4): 263–268.

    Article  CAS  PubMed  Google Scholar 

  52. Mackillop WJ. The principles of palliative radiotherapy: a radiation oncologist’s perspective. Can J Oncol 1996; 6 (Suppl 1): 5–11.

    Google Scholar 

  53. Fossa SD, Hosbach G. Short-term moderate-dose pelvic radiotherapy of advanced bladder carcinoma. A questionnaire-based evaluation of its symptomatic effect. Acta Oncol 1991; 30 (6): 735–738.

    Article  CAS  PubMed  Google Scholar 

  54. Duchesne G, Bolger J, Griffiths G, Uscinska B. Preliminary Results of an MRC (UK) Trial of Palliative Radiotherapy in Advanced Bladder Cancer (BA09). In: Royal Australasian Annual Scientific Meeting, 1998; Brisbane, 1998.

    Google Scholar 

  55. Salminen E. Unconventional fractionation for palliative radiotherapy of urinary bladder cancer. A retrospective review of 94 patients. Acta Oncol 1992; 31(4): 449454.

    Google Scholar 

  56. Holmang S, Borghede G. Early complications and survival following short-term palliative radiotherapy in invasive bladder carcinoma. J Urol 1996; 155 (1): 100–102.

    Article  CAS  PubMed  Google Scholar 

  57. Wijkstrom H, Naslund I, Ekman P, Kohler C, Nilsson B, Norming U. Short-term radiotherapy as palliative treatment in patients with transitional cell bladder cancer. Br J Urol 1991; 67 (1): 74–78.

    Article  CAS  PubMed  Google Scholar 

  58. Moonen L, Voet HVD, de Nijs R, Hart AAM, Horenblas S, Bartelink H. Muscle-invasive bladder cancer treated with external beam radiotherapy: pretreatment prognostic factors and the predictive value of cystoscopic re-evaluation during treatment. Radiot Oncol 1998: 49 (2) 145–155.

    Article  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2001 Springer Science+Business Media New York

About this chapter

Cite this chapter

Gospodarowicz, M.K., Milosevic, M.F., Warde, P., Porter, A.T. (2001). Clinical Situations for the Role of Radiation Therapy in the Treatment of Bladder Cancer. In: Droller, M.J. (eds) Bladder Cancer. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-097-1_12

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-097-1_12

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-202-5

  • Online ISBN: 978-1-59259-097-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics