Long term results of short-course preoperative radiotherapy and radical cystectomy for bladder cancer

Abstract

(Background) The long-term effects of preoperative high-dose short- course radiotherapy for bladder cancer are controversial. (Methods) We reviewed 144 patients with an invasive or grade 3 bladder cancer who underwent radical cystectomy with or without preoperative radiotherapy between 1978 and 1990. Preoperatively, short-course radiation (16 Gy) was given to 100 patients, conventional pelvic radiation (median 31 Gy) to 12 patients and no radiation to 32 patients. The median follow-up period was 7 years 11 months. One patient was lost to follow-up. (Results) The overall survival rates did not differ among the short-course, conventional and no- radiation groups. However, if limited to the patients with stage pT2 or higher, or with grade 2 or 3, the survival rates were significantly higher in the short-course radiation group than in the other groups. Although preoperative short-course radiation tended to lower the pathological stage, the presence or absence of down staging did not influence the survival rates. (Conclusion) Preoperative short-course radiotherapy may possibly improve the prognosis of cystectomized patients with clinical stage T2 or T3, or squamous cell cancer.