TURKISH JOURNAL OF ONCOLOGY 2006 , Vol 21 , Num 4
Factors affecting local control, distant recurrence and survival in patients with locally advanced bladder cancer treated by definitive radiotherapy or chemoradiotherapy
Murat ÇALOĞLU,1 Vuslat YÜRÜT-ÇALOĞLU,1 Mert SAYNAK,1 Ruşen COŞAR-ALAS,1 Hakan KARAGÖL,2 Mustafa KAPLAN,3 Kamuran İBİŞ,1 Cem UZAL1
1Trakya Üniversitesi Tıp Fakültesi, Radyasyon Onkolojisi Anabilim Dalı, Edirne, Turkey
2Trakya Üniversitesi Tıp Fakültesi, Medikal Onkoloji Bilim Dalı, Edirne, Turkey
3Trakya Üniversitesi Tıp Fakültesi, Üroloji Anabilim Dalı, Edirne, Turkey
OBJECTIVES
Treatment results of 34 patients with bladder cancer admitted to Department of Radiation Oncology, Medicine Faculty of Trakya University between October 1997 and June 2005 were retrospectively analyzed. Prognostic factors associated with survival were determined.

METHODS
Their median age was 69 years (range 44-93). Thirty patients (88%) were male and 4 patients (12%) were female. Histopathological diagnosis was transitional cell carcinoma in 20 (59%) patients. Chemotherapy was administered concomitantly with radiotherapy to the 11 (32.35%) of the patients. The median radiotherapy dose was 62.5 (35-68) Gy. The median follow-up was 22 months (5-76 months). Median survival and median disease-free survival were 14.2 months (3.8-57.5) and 10 months (0-55), respectively.

RESULTS
Three years loco-regional control, metastasis free survival, disease free survival and overall survival rates were 76.5%, 72.2%, 55% and 41.1%, respectively. Epidermoid carcinoma histopathology (p=0.002), not performing concomitant chemotherapy (p=0.003), applying carboplatin instead of cisplatin with radiotherapy (p=0.004) and not conducting complete TURB (p=0.008) were significant poor prognostic factors on loco-regional control. Undifferentiated cell type (p=0.012) and not performing concomitant chemotherapy (p=0.046) were significant adverse factors on distant metastases. Factors that affect overall survival were tumor in stage T4 (p=0.05), hemoglobin value below 10 g/dl (p=0.032) and not performing concomitant chemo-radiotherapy (p=0.017) and complete TURB (p=0.049).

CONCLUSION
Complications of radiotherapy were acceptable. For the treatment of muscle invasive locally advanced bladder cancer, RT combined with cisplatin is an acceptable treatment option. Moreover, complete TURB before RT is important both for local control and for survival. Keywords : Bladder neoplasms/mortality/radiotherapy/therapy; cisplatin/ dosage; radiotherapy dosage; survival rate