LONG-TERM FOLLOW-UP OF A BLADDER-CARCINOMA COHORT - QUESTIONABLE VALUE OF RADICAL RADIOTHERAPY

Purpose: We studied the outcome of radical radiotherapy for bladder ca rcinoma in all patients from a well-defined region. Materials and Meth ods: All 701 cases with a new bladder carcinoma between 1987 and 1988 in Western Sweden were prospectively documented and followed until 199 4. Between 1987 and 1994, 74 of the 701 patients (mean age 73 years, r ange 54 to 88) were treated with external beam radiotherapy (60 Gy. or more). Results: At least 84% of the patients had persistent tumor, a local recurrence or a symptomatic contracted bladder after external be am radiotherapy. Seven patients (9.5%) died of early or late treatment related complications Of only 8 long-term survivors 6 had undergone r adical transurethral resection before external beam radiotherapy. Conc lusions: Full dose external beam radiotherapy in patients with bladder carcinoma was associated with high local recurrence and serious compl ication rates. It must be questioned whether elderly patients actually benefit from full dose radiotherapy.