The value of selected clinical factors in radical radiotherapy for bladder cancer ? the analysis of clinical material from 1975 to 1995
Article published in Urologia Polska 2005/58/3.

authors

Wojciech Majewski, Stanisław Majewski, Rafał Tarnawski: Zakład Radioterapii, Centrum Onkologii ? Instytut im. Marii Skłodowskiej-Curie, Oddział w Gliwicach
Kierownik zakładu: prof. dr hab. Bogusław Maciejewski

keywords

urinary bladder, bladder cancer, radiotherapy, prognostic factors

summary

The aim of the study.

Evaluation of selected, clinical prognostic factors in relation to the efficacy of the radical radiotherapy in patients with stage T2-T3 bladder cancer.

Material and methods.

The study group consists of 480 patients with stage T2-T3 bladder cancer treated with radical radiotherapy, between 1975 and 1995. There were 433 men (90%) and 47 women (10%), mean patients' age was 59 years. In 167 patients (35%) tumour was staged as T2 and in 313 patients (65%) as T3. The mean pre-treatment hemoglobin concentration was 13.7 g/dl (6.9-17.8 g/dl), the mean pre-treatment bladder capacity was 270 ml (120-700 ml). In 332 patients (69%) no ureteral obstruction was seen, in 86 patients (18%) there was observed unilateral ureteral obstruction, in the remaining patients the assessment of ureteral obstruction was difficult to define or insufficient data did not allow exact evaluation. Patients had been treated with 60Co photons or 9-23 Mv X photons. The mean total radiation dose to the bladder was 65.5 Gy and mean overall treatment time was 51 days. Prognostic value of selected clinical factors was evaluated in relation to overall survival and local control rates. The selected prognostic factors were analysed, as follows: sex, age, T-stage, pre-treatment hemoglobin concentration, pre-treatment bladder capacity, ureteral obstruction.

Results.

Median follow-up was 76 months. The actuarial 5-year overall survival and local control were 40% and 47% respectively. On multivariate analysis, T-stage (p=0.046), bladder capacity (p=0.003), hemoglobin concentration (p=0.007) and ureteral obstruction (p=0.025) were significant prognostic factors in relation to local control. With respect to the overall survival, T-stage (p=0.006), bladder capacity (p=0.0004) and hemoglobin concentration (p=0.0001) remained significant prognostic factors.

Conclusions.

Among the evaluated clinical factors, the strongest prognostic value in relation to the efficacy of radiotherapy for bladder cancer had: hemoglobin concentration, bladder capacity and T-stage. Ureteral obstruction was significant prognostic factor in relation to the local control.

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