ONCE WEEKLY IRRADIATION FOR CARCINOMA OF THE BLADDER

Purpose: A dose-searching study was carried out treating selected elde rly patients or patients with poor performance with bladder cancer wit h once weekly fractionation to determine an effective dose per fractio n, and to evaluate acute and late effects resulting from this schedule . Methods and Materials: Seventy patients with invasive transitional c ell carcinoma of the bladder were entered in the study, The dose used was 36-39 Gy in six fractions over 35 days in 27 patients (Group 1), T he remaining 43 patients were treated with 34.5 Gy in six fractions ov er 39 days (Group 2). Results: Six patients developed Grade 1-2 Europe an Organization for Research on Treatment of Cancer (EORTC) bowel reac tion, Three patients in Group 1 developed Grade 3 late bowel reaction and a fourth patient developed Grade 4 reaction requiring colostomy, H owever, only one patient in Group 2 developed Grade 3 reaction. The di fference between the two groups was statistically significant (chi(2) = 3.794, P = 0.05). Conclusions: The acute and late reaction as well a s the 5-year free survival for patients in Group 2 compare favorably w ith daily treatment, We conclude that 34.5 Gy given over 39 days is a safe and effective treatment for selected patients with bladder cancer .