Journal article
Split-course radiotherapy of carcinoma of the urinary bladder stages C and D1. A radiation therapy oncology group study
American journal of clinical oncology, v 8(3), pp 185-199
Jun 1985
PMID: 4050737
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
<p>One hundred forty-eight patients with advanced carcinoma of the urinary bladder Stages C or D1 were randomized between continuous-course radiotherapy (6,000 cGy in 30 fractions of 200 cGy each, over 6 weeks) and split-course radiotherapy (2,750 cGy in 10 fractions of 275 cGy each, over 2 weeks; a rest period of 3 weeks; 2,750 cGy in 2 weeks); 139 are analyzed in this report. Ninety-four percent of the patients have been followed at least 5 years or until death. The patients ranged in age from 45 to 80 with a median of 69. Seventy-six percent of the patients were males and 58% had Stage C disease. In patients with information on the size of the tumor, in 66% the lesion measured 5 cm or larger; 26% had a diameter of 8 cm or larger. In general, the treatment groups were well balanced with respect to patient characteristics. Both treatment groups tolerated therapy well. Eighty-seven percent of the patients completed therapy, 66% as planned. Fifty-four percent experienced at least one severe reaction, with the most common types being diarrhea (28%), frequency of urination (24%), soreness or burning on urination (25%), and urgency of urination (19%). Late effects of therapy were minimal. Median survival times were 11.5 months and 9.4 months for continuous-course and split-course, respectively. The treatment differences were not significant (p = 0.88; Mantel-Haenszel stratified by stage and sex). Forty percent of the patients became free of all clinically detectable disease following radiotherapy either alone or in combination with additional surgery (40% for continuous-couse, 4% cleared by surgery, and 39% for split-course, 3% cleared by surgery). When the tumor measured less than 5 cm, the cleaseance rate was 61% (20/33) vs. 33% (13/39) for 5-7.9 cm, and 24% (6/25) for 8 cm or larger (p < 0.01; .chi.2 test for linear trend). For those who became disease free, median time disease free within the irradiated volume was 72 months for continuous-course and is currently undefined for split-course; median time disease free was 28 months and undefined, respectively. There were no significant treatment differences in tumor control for any of these endpoints. The ultimate long-term tumor control in the pelvis was 28% (19/68) for continuous- and 25% (18/71) for split-course therapy. This trial supports the hypothesis that split-course therapy, as used in this study, is as effective as continuous course therapy for patients with advanced (Stage C or D1) carcinoma of the urinary bladder.</p>
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Details
- Title
- Split-course radiotherapy of carcinoma of the urinary bladder stages C and D1. A radiation therapy oncology group study
- Creators
- V. A Marcial - Hahnemann University HospitalD. A Amato - Hahnemann University HospitalL. W Brady - Hahnemann University HospitalR. J Johnson - Hahnemann University HospitalR Goodman - Hahnemann University HospitalK. L Martz - Hahnemann University HospitalJ. A Hanley - Hahnemann University Hospital
- Publication Details
- American journal of clinical oncology, v 8(3), pp 185-199
- Publisher
- Lippincott Williams & Wilkins; PHILADELPHIA
- Number of pages
- 15
- Resource Type
- Journal article
- Language
- English
- Web of Science ID
- WOS:A1985ASP2100001
- Scopus ID
- 2-s2.0-0022203514
- Other Identifier
- 991021901007804721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Oncology