Curative radiotherapy, with or without concurrent chemotherapy, is recognized as a standard treatment option for muscle-invasive bladder cancer.
It is commonly used for two distinct groups of patients: either for those medically unfit for surgery, or as part of a 'bladder preserving' management plan incorporating the possibility of salvage cystectomy. However, in both situations, the approach to radiotherapy varies widely around the world. The Australian and New Zealand Faculty of Radiation Oncology Genito-Urinary Group recognised a need to develop consistent, evidence-based guidelines for patient selection and radiotherapy technique in the delivery of curative radiotherapy. Following a workshop convened in May 2009, a working party collated opinions and conducted a wide literature appraisal linking each recommendation with the best available evidence. This process was subject to ongoing re-presentation to the Faculty of Radiation Oncology Genito-Urinary Group members prior to final endorsement. These Guidelines include patient selection, radiation target delineation, dose and fractionation schedules, normal tissue constraints and investigational techniques. Particular emphasis is given to the rationale for the target volumes described. These Guidelines provide a consensus-based framework for the delivery of curative radiotherapy for muscle-invasive bladder cancer. Widespread input from radiation oncologists treating bladder cancer ensures that these techniques are feasible in practice. We recommend these Guidelines be adopted widely in order to encourage a uniformly high standard of radiotherapy in this setting, and to allow for better comparison of outcomes.
Written by:
Hindson BR, Turner SL, Millar JL, Foroudi F, Gogna NK, Skala M, Kneebone A, Christie DR, Lehman M, Wiltshire KL, Tai KH. Are you the author?
William Buckland Radiation Oncology, Alfred Health Department of Surgery, Monash University, Melbourne, Victoria; Department of Radiation Oncology, Westmead Cancer Care Centre, Westmead, New South Wales; Department of Epidemiology and Preventative Medicine, Monash University Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria; Mater Radiation Oncology Centre, Princess Alexandra Hospital, Brisbane, Queensland; WP Holman Clinic, Hobart, Tasmania Northern Sydney Cancer Centre Northern Clinical School, University of Sydney, Sydney, New South Wales; Premion, John Flynn Private Hospital Princess Alexandra Hospital, Brisbane, Queensland Department of Pathology, University of Melbourne, Victoria, Australia.
Reference: J Med Imaging Radiat Oncol. 2012 Feb;56(1):18-30.
doi: 10.1111/j.1754-9485.2011.02336.x
PubMed Abstract
PMID: 22339742
