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A randomized trial of hypofractionated schedules of palliative radiotherapy in the management of bladder carcinoma: Results of Medical Research Council Trial BA09

Lookup NU author(s): Dr James Roberts

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Abstract

Purpose: To compare the efficacy and toxicity of two hypofractionated radiotherapy schedules for the improvement of local symptoms from muscle-invasive bladder cancer. Methods and Materials: A multicenter randomized. trial was conducted comparing the efficacy and toxicity of two radiotherapy schedules (35 Gy in 10 fractions and 21 Gy in 3 fractions) for symptomatic improvement in patients considered unsuitable for curative treatment through disease stage or comorbidity. The primary outcome measures were overall symptomatic improvement of bladder-related symptoms at 3 months and changes in bladder- and bowel-related symptoms from pretreatment to end-of-treatment and 3-month assessments. Overall symptomatic improvement was defined prospectively as the improvement in one bladder-related symptom of at least one grade at 3 months, with no deterioration in any other bladder-related symptom. Results: Five hundred patients were recruited, but data on symptomatic improvement at 3 months was only available on 272 patients. Of these, 68% achieved symptomatic improvement (71% for 35 Gy, 64% for 21 Gy), with no evidence of a difference in efficacy or toxicity between the two arms. There was no evidence of a difference in survival between the two schedules (hazard ratio [HR] = 0.99, 95% CI 0.82-1.21, p = 0.933). Conclusion: This is the largest prospective trial to date in the palliative treatment of bladder cancer, and provides baseline data against which other results may be compared. The use of 21 Gy in 3 fractions appears as effective as 35 Gy in 10 fractions, although modest differences in survival, symptomatic improvement rates, and toxicity can not be reliably excluded. (C) 2000 Elsevier Science Inc.

Publication metadata

Author(s): Duchesne GM, Bolger JJ, Griffiths GO, Roberts JT, Graham JD, Hoskin PJ, Fossa SD, Uscinska BM, Parmar MKB, Med Res Council Bladder Canc Worki

Publication type: Article

Publication status: Published

Journal: International Journal of Radiation: Oncology - Biology - Physics

Year: 2000

Volume: 47

Issue: 2

Pages: 379-388

ISSN (print): 0360-3016

ISSN (electronic): 1879-355X

Publisher: Elsevier

URL: http://www.redjournal.org/article/S0360-3016%2800%2900430-2/abstract

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