Hafeez, S., McDonald, F., Lalondrelle, S., McNair, H., Warren-Oseni, K., Jones, K., Harris, V., Taylor, H., Khoo, V., Thomas, K., Hansen, V., Dearnaley, D., Horwich, A., Huddart, R. (2017) Clinical Outcomes of Image Guided Adaptive Hypofractionated Weekly Radiation Therapy for Bladder Cancer in Patients Unsuitable for Radical Treatment. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 98 (1). pp. 115-122. ISSN 0360-3016

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Abstract

Purpose and Objectives: We report on the clinical outcomes of a phase 2 study assessing image guided hypofractionated weekly radiation therapy in bladder cancer patients unsuitable for radical treatment. Methods and Materials: Fifty-five patients with T2-T4aNx-2M0-1 bladder cancer not suitable for cystectomy or daily radiation therapy treatment were recruited. A "plan of the day" radiation therapy approach was used, treating the whole (empty) bladder to 36 Gy in 6 weekly fractions. Acute toxicity was assessed weekly during radiation therapy, at 6 and 12 weeks using the Common Terminology Criteria for Adverse Events version 3.0. Late toxicity was assessed at 6 months and 12 months using Radiation Therapy Oncology Group grading. Cystoscopy was used to assess local control at 3 months. Cumulative incidence function was used to determine local progression at 1 at 2 years. Death without local progression was treated as a competing risk. Overall survival was estimated using the Kaplan-Meier method. Results: Median age was 86 years (range, 68-97 years). Eighty-seven percent of patients completed their prescribed course of radiation therapy. Genitourinary and gastrointestinal grade 3 acute toxicity was seen in 18% (10/55) and 4% (2/55) of patients, respectively. No grade 4 genitourinary or gastrointestinal toxicity was seen. Grade >= 3 late toxicity (any) at 6 and 12 months was seen in 6.5% (2/31) and 4.3% (1/23) of patients, respectively. Local control after radiation therapy was 92% of assessed patients (60% total population). Cumulative incidence of local progression at 1 year and 2 years for all patients was 7% (95% confidence interval [CI] 2%-17%) and 17% (95% CI 8%-29%), respectively. Overall survival at 1 year was 63% (95% CI 48%-74%). Conclusion: Hypofractionated radiation therapy delivered weekly with a plan of the day approach offers good local control with acceptable toxicity in a patient population not suitable for radical bladder treatment. (C) 2017 The Author(s). Published by Elsevier Inc.

Item Type:	Article
Authors (ICR Faculty only):	Huddart, Robert and Dearnaley, David and Horwich, Alan and Khoo, Vincent and Mcdonald, Fiona
All Authors:	Hafeez, S., McDonald, F., Lalondrelle, S., McNair, H., Warren-Oseni, K., Jones, K., Harris, V., Taylor, H., Khoo, V., Thomas, K., Hansen, V., Dearnaley, D., Horwich, A., Huddart, R.
Additional Information:	ISI Document Delivery No.: EX2SF Times Cited: 0 Cited Reference Count: 21 Hafeez, Shaista McDonald, Fiona Lalondrelle, Susan McNair, Helen Warren-Oseni, Karole Jones, Kelly Harris, Victoria Taylor, Helen Khoo, Vincent Thomas, Karen Hansen, Vibeke Dearnaley, David Horwich, Alan Huddart, Robert NHS Supported in part by NHS funding to the NIHR Biomedical Research Centre for Cancer and to Cancer Research UK. 0 ELSEVIER SCIENCE INC NEW YORK INT J RADIAT ONCOL
Uncontrolled Keywords:	RADIOTHERAPY CARCINOMA PRESERVATION IRRADIATION VOLUME TRIAL
Research teams:	ICR divisions > Radiotherapy and Imaging > Clinical Academic Radiotherapy (Dearnaley) ICR divisions > Radiotherapy and Imaging > Clinical Academic Radiotherapy (Horwich) ICR divisions > Radiotherapy and Imaging > Clinical Academic Radiotherapy (Huddart) Clinical Units > Urology Unit Clinical Units > Radiotherapy ICR divisions > Radiotherapy and Imaging > Thoracic Radiotherapy
Depositing User:	Barry Jenkins
Date Deposited:	07 Jul 2017 15:07
Last Modified:	07 Jul 2017 15:07
URI:	http://publications.icr.ac.uk/id/eprint/16027

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