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The Rationale for Post-Operative Radiation in Localized Bladder Cancer
Local-regional recurrence for patients with ≥pT3 disease after radical cystectomy is a significant problem. Chemotherapy has not been shown to reduce the risk of local-regional recurrences in randomized prospective trials, and salvage therapies for local-regional failure are rarely successful. There...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
IOS Press
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5271478/ https://www.ncbi.nlm.nih.gov/pubmed/28149931 http://dx.doi.org/10.3233/BLC-160081 |
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author | Baumann, Brian C. Sargos, Paul Eapen, Libni J. Efstathiou, Jason A. Choudhury, Ananya Bahl, Amit Murthy, Vedang Ballas, Leslie K. Fonteyne, Valérie Richaud, Pierre M. Zaghloul, Mohamed S. Christodouleas, John P. |
author_facet | Baumann, Brian C. Sargos, Paul Eapen, Libni J. Efstathiou, Jason A. Choudhury, Ananya Bahl, Amit Murthy, Vedang Ballas, Leslie K. Fonteyne, Valérie Richaud, Pierre M. Zaghloul, Mohamed S. Christodouleas, John P. |
author_sort | Baumann, Brian C. |
collection | PubMed |
description | Local-regional recurrence for patients with ≥pT3 disease after radical cystectomy is a significant problem. Chemotherapy has not been shown to reduce the risk of local-regional recurrences in randomized prospective trials, and salvage therapies for local-regional failure are rarely successful. There is promising evidence, particularly from a recent Egyptian NCI trial, that radiation therapy plus chemotherapy can significantly reduce local recurrences compared to chemotherapy alone, and that this improvement in local-regional control may translate to meaningful improvements in disease-free and overall survival with acceptable toxicity. In light of the high rates of local failure following cystectomy for locally advanced disease and the progress that has been made in identifying patients at high risk of failure and the patterns of failure in the pelvis, the NCCN guidelines were revised in 2016 to include post-operative radiotherapy as an option to consider for patients with ≥pT3 disease. Despite advances in our understanding of the problem of local-regional failure after cystectomy and the potential role of adjuvant radiotherapy, the question of whether adjuvant radiotherapy should have a defined role for patients with locally advanced urothelial carcinoma has not yet been determined. The results of the NRG, European, Indian, and Egyptian trials on adjuvant radiotherapy are eagerly awaited. While none of these trials on their own may provide definitive conclusions, their aggregate outcomes will help clarify whether this treatment should have a role in the management of patients with locally advanced bladder cancer. |
format | Online Article Text |
id | pubmed-5271478 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | IOS Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-52714782017-01-30 The Rationale for Post-Operative Radiation in Localized Bladder Cancer Baumann, Brian C. Sargos, Paul Eapen, Libni J. Efstathiou, Jason A. Choudhury, Ananya Bahl, Amit Murthy, Vedang Ballas, Leslie K. Fonteyne, Valérie Richaud, Pierre M. Zaghloul, Mohamed S. Christodouleas, John P. Bladder Cancer Review Local-regional recurrence for patients with ≥pT3 disease after radical cystectomy is a significant problem. Chemotherapy has not been shown to reduce the risk of local-regional recurrences in randomized prospective trials, and salvage therapies for local-regional failure are rarely successful. There is promising evidence, particularly from a recent Egyptian NCI trial, that radiation therapy plus chemotherapy can significantly reduce local recurrences compared to chemotherapy alone, and that this improvement in local-regional control may translate to meaningful improvements in disease-free and overall survival with acceptable toxicity. In light of the high rates of local failure following cystectomy for locally advanced disease and the progress that has been made in identifying patients at high risk of failure and the patterns of failure in the pelvis, the NCCN guidelines were revised in 2016 to include post-operative radiotherapy as an option to consider for patients with ≥pT3 disease. Despite advances in our understanding of the problem of local-regional failure after cystectomy and the potential role of adjuvant radiotherapy, the question of whether adjuvant radiotherapy should have a defined role for patients with locally advanced urothelial carcinoma has not yet been determined. The results of the NRG, European, Indian, and Egyptian trials on adjuvant radiotherapy are eagerly awaited. While none of these trials on their own may provide definitive conclusions, their aggregate outcomes will help clarify whether this treatment should have a role in the management of patients with locally advanced bladder cancer. IOS Press 2017-01-27 /pmc/articles/PMC5271478/ /pubmed/28149931 http://dx.doi.org/10.3233/BLC-160081 Text en IOS Press and the authors. All rights reserved https://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License (https://creativecommons.org/licenses/by-nc/4.0/) , which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Baumann, Brian C. Sargos, Paul Eapen, Libni J. Efstathiou, Jason A. Choudhury, Ananya Bahl, Amit Murthy, Vedang Ballas, Leslie K. Fonteyne, Valérie Richaud, Pierre M. Zaghloul, Mohamed S. Christodouleas, John P. The Rationale for Post-Operative Radiation in Localized Bladder Cancer |
title | The Rationale for Post-Operative Radiation in Localized Bladder Cancer |
title_full | The Rationale for Post-Operative Radiation in Localized Bladder Cancer |
title_fullStr | The Rationale for Post-Operative Radiation in Localized Bladder Cancer |
title_full_unstemmed | The Rationale for Post-Operative Radiation in Localized Bladder Cancer |
title_short | The Rationale for Post-Operative Radiation in Localized Bladder Cancer |
title_sort | rationale for post-operative radiation in localized bladder cancer |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5271478/ https://www.ncbi.nlm.nih.gov/pubmed/28149931 http://dx.doi.org/10.3233/BLC-160081 |
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