Contemporary results of radical radiotherapy for bladder transitional cellcarcinoma in a district general hospital with cancer-centre status

Objective To assess the current efficacy and safety of definitive external beam radiotherapy (EBRT) in the treatment of invasive bladder transitional cell carcinoma (TCC) in a district general hospital with cancer-centre stat us. Patients and Methods The case notes of all patients with bladder TCC underg oing EBRT with curative intent over an 8-year period (1988-95) were reviewe d. Additional missing outcome data were collected. Results In all, 120 patients (109 men; median age 70 years, range 34-90) un derwent radical EBRT (40-65 Gy; fraction median = 20) over the 8-year perio d, Staging, as assessed by examination under anaesthesia and computed tomog raphy, was T1 in 16%, T2 in 43%, T3 in 38% and T4 in 3%. In 96 patients (80 %) the tumour was poorly differentiated (G3), The overall morbidity at 12 m onths was 12%; proctitis occurred in nine patients (8%) and cystitis in fiv e (4%). Sixty-seven patients (59%) developed a local recurrence and in 36 ( 30%) this was invasive. The overall median survival was 60 months. Thirty-t hree patients underwent salvage cystectomy with a subsequent median surviva l of 12.5 months. Conclusion Modern radical multifraction EBRT in invasive bladder TCC has a low morbidity, with an overall median survival of 5 years.