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Acute and late toxicity in radical radiotherapy for bladder cancer
Clinical Oncology, 09/09/09

Majewski W et al. – The severity of acute bowel toxicity is related to pelvic irradiation and dose intensity. The severity of acute bladder toxicity depends on T-stage. The increase in dose intensity is associated with shorter latency to maximum acute bladder and bowel toxicity. The severity of acute bladder and bowel toxicity influences the risk of late effects from those organs.

Methods

The retrospective analysis was based on 487 patients with T2, T3 bladder cancer, treated with radiotherapy
The pelvis was irradiated electively in 303 patients; in the remaining patients, the bladder alone was treated
The mean total radiation dose to the bladder was 65.5Gy
The median follow-up was 76 months

Results

Seven patients did not complete treatment due to excessive acute toxicity
The incidence of grade ≥ 3 acute bladder and bowel toxicity was 5 and 3%, respectively
The actuarial, 5-year incidence of grade ≥ 3 late bladder and bowel toxicity was 12 and 3%, respectively
The most important factors influencing acute toxicity were: T-stage for the bladder and pelvic irradiation and dose intensity for the bowels
The latency of both early bladder and bowel toxicity was correlated with dose intensity
The most important factor influencing late bladder toxicity was acute toxicity score
Late bowel toxicity was also influenced by acute bowel toxicity

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