21 Urinary Bladder Cancer

Urinary Bladder Cancer

11

THE GEC ESTRO HANDBOOK OF BRACHYTHERAPY | Part II: Clinical Practice Version 1 - 21/04/2015

Table 22.1: Five-year local control, cause-specific survival, and overall survival.

NUMBEROF PATIENTS

YEAR

5-YEAR

AUTHOR

Cause-specific survival

Local control

Overall survival

T1 T2 T3

100% 65% 62%

100% 70% 38%

69% 60% 38% 65% 73% 70% 57% 62% 65%

De Crevoisier (36)

2004

58

Nieuwenhuijzen (32)

2005 2007 2008 2009 2012 2013

108 122 111

T1-T2 T1-T3 T1-T2 T1-T2 T1-T3 T2-T3

-

75%

Blank (14) Onna (34)

76%

- -

82% 71%

van der Steen-Banasik (23)

89

Koning (21) Aluwini (31)

1040

75% 80%

-

192

75%

tinguished from a local relapse and unnecessary biopsies must be prevented. If biopsy is performed, the probability of fistula formation will increase. Bladder function is poorly evaluated in the majority of studies. Blank evaluated bladder function in a subset of patients (14). In 11% of cases they observed a deterioration of bladder capacity at follow-up. About 25% of patients reported increased urinary frequency.

Only preliminary results are available on late effects from the laparoscopic technique. Of 30 patients treated with laparoscopy, only 1 late effect was noted (35).

14. KEY MESSAGES

• Bladder brachytherapy is indicated for a selected group of patients with muscle-invasive bladder cancer

• Local control and overall survival rates with brachytherapy are in the same range as with cystectomy

• With brachytherapy a high rate of bladder sparing is obtained

• The toxicity profile with PDR is favourable, as it was in the past with LDR

• Experience with HDR is still limited

• Laparoscopic and robot-assisted implantation is an emerging technique and will replace the classical suprapubic approach