Retrospective study of effect of post-operative radiotherapy on control of cancer urinary bladder stage two and three

Document Type : Original Article


Department of Clincal Oncology and Nuclear Medicine, Faculty of Medicine, Sohag University.


Aim of the work: evaluate benefit of post-operative radiotherapy in stage two and three bladder cancer after radical cystectomy as regard LRC, OS, DFS, and MFS and evaluate toxicity profile.
Patients and Method: A retrospective study of sixty two patients with pathologically proven bladder cancer who presented to the clinical oncology department, sohag University hospital from januray 2010 to December 2014. All of them underwent RC or anterior pelvic exenteration followed by post-operative radiotherapy after surgery for 5000 cGy in 25 fractions, over 5 weeks using 2D technique. This study was conducted by hand search in the files and radiotherapy sheet of these patients.
Results: Sixty two eligible bladder cancer patients were included in our study; it includes 39 males (63%) and 23females (37%), with a male to female ratio of 1.7:1. The mean age was 58.15 years.Transitional cell carcinoma representing (61%) of cases while SCC representing (39%) of cases
Forty eight patients of our study developed acute and chronic toxicities (77%), Out of 62 eligible bladder cancer patients, 2 patients (3%) developed local recurrence, while 8 patients (13%) developed distant metastasis, The 2, 3 and 5yr OS of the whole cohort of patients are 66%, 64% and53.5% respectively, The 2, 3 and 5yr MFS of whole cohort of patients was 90%,84% are 80.5% respectively ,  The 2, 3 and 5yr LRC of whole cohort of patients was 95%,95% and 95% respectively.
Conclusion: In our retrospective study, post-operative radiotherapy showed good OS, DFS, LRCand MFS rates that were in agreement with some previous studies. Due to the small number of patients, the relatively short follow up periods and the statistical bias linked to retrospective design of clinical studies, further prospective studies with longer follow up periods are warranted to better evaluate such an effect  better with using new radiotherapy modalities such as CRT and IMRT.

-Torre LA, Bray F, et al (2015): Global cancer statistics, 2012. CA Cancer J Clin; 65:87.
2-Amal S. Ibrahim, Hussein M. Khaled, et al (2014): Journal of Cancer Epidemiology Volume 2014 (2014), Article ID 437971, 18 pages.
3-Gouda, I., Mokhtar, N., Bilal, D., et al (2007);Bilharziasis and Bladder Cancer: Journal of the Egyptian National Cancer Institute, 19, 158-162.
4-Bolenz, C, Ho, R, Nuss, G.R, et al. (2010) ,BJU International, 106, 1324-1329.
5-Ghoneim MA, El-Mekresh MM, El-Baz MA, (1997): Radical cystectomy for car- cinoma of bladder: Critical evaluation of the results of 1026 cases. J. Urol., 158: 393.
6-Abol-Enein, H., et al. (2005): Neoadjuvant Chemotherapy for Invasive Bladder Cancer. Cochrane Database of Systematic Reviews, Article ID: CD005246
7-Zaghloul MS, Awwad HK, (1992),Int J Radiat Oncol Biol Phys; 23: 511-7.
8-Madersbacher S, Schmidt J, Eberle JM, et al (2003): Long-term outcome of ileal conduit diversion. J Urol; 169: 985.
9-Reisinger SA, Mohiuddin M,et al (1992): Combined pre- and postoperative adjuvant radiation therapy for bladder cancer. Int J Radiat Oncol Biol Phys; 24: 463-8
10-Nicholas D. James, Syed A. Hussain,et al (2012) ,N Engl J Med 2012; 366:1477-1488.
11-Balci, U., Ozer, K., Gorgel, S.N., Sefik, E., et al (2013): World Journal of Urology, 31, 1177-1182.
12-De-Neve W., Lybeert M.L., ,et al (1995): Radiotherapy for 72 T3 carcinoma of the bladder: the influence of over all treatment time. Radiather Oncol: 36: 183-188.
13-Safwat A. and Bond S,et al (1999):Unplanned treatment gaps in post-operative, Radiotherapy of carcinoma in the bilharzial bladder, the results of an audit. J. Egypt Nat. Cancer Inst., 11: 271-277.
14-Zaghloul, M.S., Nouh, A., Nazmy, Zaghloul, A.S., et al ( 2006)  ,Urologic Oncology: 24, 13-20.
15-Zaghloul M.S,et al (1996): Distant metastasis from bilharzial blad- der cancer.
Cancer 77: 743-749
16-El-Sebai I, et al (1983): Bladder cancer, CRC Press, Vol., II: 163-197.