Pre-operative and definitive radiation therapy

Abstract

The majority of bladder cancer patients present with superficial disease and are managed with conservative measures. Approximately 20–25% present with muscle-invasive bladder cancer that is potentially life threatening and requires radical treatment. Definitive radiation therapy (RT) has been used for muscle-invasive bladder cancer since the early 1900s and there is evidence that patients can achieve durable local control and maintain a functional bladder without a compromise in the overall survival.1 However, the standard North American approach to the management of muscle-invasive bladder cancer is radical cystectomy.2 In the past few decades, radical radiation therapy has been used infrequently and mostly when patients either refused or were not suitable for radical cystectomy. Therefore there is a limited amount of information on the precise role that radiation therapy plays in the management of bladder cancer.