Brachytherapy with iridium-192 for bladder cancer

Objective: Patients with invasive bladder cancer often need radical cystect omy with its implications on quality of life, Bladder preservation combinin g surgery and radiotherapy could maintain quality of life without compromis ing tumor control. Study Design: Twenty-eight selected patients with different stages of invas ive bladder cancer were treated with preoperative external beam radiotherap y in a dosage depending on the tumor stage. Subsequently they underwent sur gical exploration with or without partial cystectomy and insertion of sourc e carrier tubes for afterloading with iridium-192. A close follow-up consis ted of 3-monthly urine cytology, cystoscopy and yearly CT scan. Results: Sixteen patients (57%) are alive with no evidence of disease. Five patients (18%) have died of non-cancer-related causes without evidence of recurrent tumor, Tumor progression was seen in 7 patients (25%). Conclusions: Interstitial radiation can result in long-term complete remiss ion in patients with small solitary invasive bladder tumors. The afterloadi ng technique is safe and effective. The selection of patients is the most r elevant key to success. Copyright (C) 2000 S. Karger AG, Basel.