Treatment of Bladder Cancer: Radiotherapy versus Surgery

According to a study published by Cancer Research UK scientists the survival rates of bladder cancer patients treated with radiotherapy are the same as those of patients undergoing radical cystectomy. The researchers investigated the medical records of 169 patients with invasive bladder cancer that were treated in Leeds between 1996 and 2000.

Photo: Treatment of Bladder Cancer: Radiotherapy versus Surgery

The Cancer Research UK scientists compared the survival rates for the two groups five and eight years after the treatment. There were no significant differences found at either time interval: the five-year survival rate for radiotherapy patients was 56,8%, compared with 53,4% of patients treated surgically. Eight years after treatment, the survival rates were nearly equal with 54,9% and 53,4%. There was also no significant difference in the relapse rate of the treatment groups. 34% of the radiotherapy treatment group experienced recurrence, compared with 37,5% of those treated with surgery. 

"Until now surgery has been considered better than radiotherapy in the treatment of bladder cancer that has spread to the muscle wall of the bladder,” explains Dr Anne Kiltie, Cancer Research UK Clinical Centre, part of the Leeds Institute of Molecular Medicine at the University of Leeds.
Radical Cystectomy is widely regarded as the gold standard treatment for muscle-invasive bladder cancer. The study results suggest that radiotherapy could be preferred over surgery. Particularly eldery patients benefit from a radiotherapy treatment, as radical cystectomy could have a more severe impact on the quality of life. It may result in continence problems, as well as the possibility of infections or other post-surgery complications

"Although radiotherapy carries its own long term side effects, the interesting finding in our study was that the older, less fit patients did as well as the younger, fitter patients who had surgery to treat their cancer,” adds the study’s lead author. "Since bladder cancer is a disease of older people, radiotherapy will play an increasingly important role as the population ages, and this study encourages us to believe that such elderly patients will not be disadvantaged by having an alternative curative treatment to surgery for their bladder cancer."

"Evaluating the various treatment options available is important in providing the most effective and appropriate care for cancer patients. This study certainly opens the debate on which treatments should be recommended for invasive bladder cancer patients, although the research is retrospective and the cohort of patients is small, so further investigations are necessary to establish if radiotherapy should replace surgery as the 'gold standard' treatment for these patients,"concludes Dr Lesley Walker, Cancer Research UK's director of cancer information.

24.01.2008

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