[Adjuvant radiotherapy for bladder cancer in patients with risk of locoregional recurrence: Who, what and how?]

Cancer Radiother. 2017 Feb;21(1):67-72. doi: 10.1016/j.canrad.2016.08.131. Epub 2017 Feb 8.
[Article in French]

Abstract

Radical cystectomy with extended pelvic lymph node dissection remains the standard of care for non-metastatic muscle-invasive bladder cancer. Locoregional control is a key factor in the outcome of patients since it is related to overall survival, metastasis-free survival and specific survival. Locoregional recurrence rate is directly correlated to pathological results and the quality of lymphadenectomy. In addition, while pre- or postoperative chemotherapy improved overall survival, it showed no impact on locoregional recurrence-free survival. Several recent publications have led to the development of a nomogram that predicts the risk of locoregional recurrence, in order to identify patients for which adjuvant radiotherapy could be beneficial. International cooperative groups have then come together to provide the rational for adjuvant radiotherapy, reinforced by recent technical developments limiting toxicity, and to develop prospective studies to reduce the risk of relapse. The aim of this critical literature review is to provide an overview of the elements in favor of adjuvant radiation for patients treated for muscle-invasive bladder cancer.

Keywords: Adjuvant radiotherapy; Bladder neoplasm; Cystectomie; Cystectomy; Locoregional relapse; Radiothérapie adjuvante; Radiothérapie conformationelle avec modulation d’intensité; Rechute locorégionale.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoma, Transitional Cell / radiotherapy*
  • Carcinoma, Transitional Cell / surgery
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Cystectomy
  • Humans
  • Lymph Node Excision
  • Neoadjuvant Therapy / adverse effects
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / prevention & control*
  • Patient Selection
  • Prognosis
  • Radiotherapy, Adjuvant* / adverse effects
  • Risk Assessment
  • Risk Factors
  • Survival Rate
  • Treatment Outcome
  • Urinary Bladder Neoplasms / radiotherapy*
  • Urinary Bladder Neoplasms / surgery