Role of radiotherapy in the management of bladder cancer: Recommendations of the French Society for Radiation Oncology, 2025 update

Abstract

We present the recommendations of the Société française de radiothérapie oncologie (SFRO; the French society for radiation oncology) regarding the indications and techniques for external beam radiotherapy for bladder cancer. Together with radical cystectomy, trimodal therapy for well-selected patients is one of the standard-of-care treatments in the management of localized muscle invasive bladder cancer, defined as a maximal trans-urethral resection of the bladder tumour, followed by radiotherapy and concomitant chemotherapy. Adjuvant radiotherapy is an option for patients with pathological high-risk bladder cancer. In the metastatic setting, consolidative radiotherapy is still under evaluation. Palliative radiotherapy using a hypofractionated regimen is a valid option in symptomatic patients.