Indications and outcome of radiotherapy for invasive bladder cancer: review of developments during 2002.

Abstract

To highlight recent developments in the selection of patients for bladder preservation and in the optimization of outcome after radiation. Techniques in the delivery of radiation continue to improve. Increasing phase II evidence indicates that bladder preservation with multimodality approaches is safe and effective in selected patients. The list of molecular markers of bladder cancer with potential clinical relevance continues to extend. Three studies on target delineation, set-up errors and organ motion during radiation show that radiation techniques can be improved considerably thereby reducing the risk of geographical miss. Two large studies with long follow-ups report excellent outcome after bladder preserving treatment strategies using concurrent chemotherapy and radiation. Results seem comparable with those reported for contemporary radical cystectomy. Molecular characterization of bladder cancer is rapidly expanding, but has up to now no established role in the selection or tailoring of treatment options for individual bladder cancer patients.