During the period from 1977 to 1984 173 patients with a bladder carcinoma were exposed a combined operative-radiological therapy. It includes the transurethral tumor resection and the percutaneous high voltage irradiation after an interval of six weeks. After individual irradiation planning--since 1981 by means of CT--pendulum technique has been applied exclusively for careful treatment of risk organs. The total target dose (= 80% isodose) was 56 Gy with daily application of 1.8 Gy. We attained a 5-years-healing of 27%, obviously the first two years therapy beginning were deciding for fate (2-years-survival 45%). Among infiltration grade and histological type also the primary tumor localization had prognostic relevance. In locally advanced bladder carcinoma with invasion into the environment the radiotherapy gives chance for permanent healing. Acute passing side-reactions during intensive therapy, mainly as cystitis, we recorded in 2/3 of the patients. Only with the combined occurrence of cystitis and proctitis we had to record chronic effects in 2.5% of the cases for a period of more than 5 years.