ASTRO Annual Meeting
MIAMI – Administering brachytherapy after external beam
radiotherapy, plus limited surgery, resulted in a bladder conservation rate of
94% among patients with muscle-invasive bladder cancer.
According to E. Deborah Geijsen, MD, and colleagues from the
Netherlands, positive data on the outcome of adding brachytherapy to limited
surgery following EBRT in early stage muscle-invasive bladder cancer have been
reported by French, Belgian and Dutch radiation oncologists. However, this
technique is rarely used outside of these countries.
Geijsen presented results during a Scientific Session here at the 2011
ASTRO Annual Meeting.
She and colleagues developed a Dutch database to collect data
retrospectively for 1,040 patients treated with both
EBRT and brachytherapy at 12 institutions between 1983 and
2010. Partial cystectomy was performed in 247 patients. According to Geijsen,
most patients received continuous low-dose rate brachytherapy (n=819). Median
patient age was 66 years, and median follow-up was 15 months.
Tumors included: pT0 (n=2), pT1 (n=126), pT2 (n=797), pT3 (n=100), pT4
(n=1) and pTx (n=8). Differentiation grades were: well (n=13), moderately
(n=167), poorly (n=824) and undifferentiated (n=16).
The local recurrence rate was 91% at 1 year, 80% at 3 years, and 75% at
5 years; metastasis-free survival was 91% at 1 year, 80% at 3 years, and 74% at
5 years; disease-free survival was 85% at 1 year, 68% at 3 years, and 61% at 5
years; and OS was 91% at 1 year, 74% at 3 years, and 62% at 5 years.
Local recurrence only occurred among 136 patients, both local recurrence
and distant metastases among 94 patients and distant metastases only occurred
among 145 patients. Forty-nine of the local recurrences were muscle-invasive,
190 were non-muscle-invasive and 31 were both muscle-invasive and
non-muscle-invasive; 60 were unknown, according to Geijsen. Sixty patients
underwent cystectomy as salvage treatment.
Outcomes were not significantly different among departments. However,
type of brachytherapy had a significant effect on recurrence rate in favor of
PDR (P<.005). This difference remained constant after multivariate
“This is the largest cohort of
bladder brachytherapy with good local control rates at 5
years of 75%. It is comparable to the cystectomy series, and the bladder
conservation rate is 94%. We think that brachytherapy should be offered and
discussed with a selected group of patients,” Geijsen said.
For more information:
- Geijsen ED. Abstract #141. Presented at: 2011 ASTRO Annual Meeting;
Oct. 2-6, 2011; Miami.
Disclosure: The researchers report no relevant financial