Introduction:
Radiation therapy (XRT) represents a possible treatment for high-risk non-muscle invasive bladder cancer (NMIBC). However, little is known about the clinical outcomes and the quality of evidence supporting its use. Herein, we performed a systematic review and meta-analysis to evaluate XRT in the treatment of patients with high-risk NMIBC.
Methods:
Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, Scopus and Web of Science were searched for high-risk NMIBC (high grade T1, T1/Ta with associated risk features: CIS, multifocality, > 5cm in diameter) treated with primary XRT. Recurrence-free survival (RFS), cancer-specific-survival (CSS) and overall survival (OS) and the rates of salvage cystectomy and progression to metastatic disease represented the primary outcomes. Meta-analysis was performed for summary treatment effects using a random effects model
Results:
Data from 13 studies met the search criteria and were pooled for the primary outcomes yielding 746 patients. The 5-year rates of RFS, CSS and OS were 54% (95% CI = 38% – 70%), 86% (95% CI = 80% – 92%), and 72% (95% CI = 64% – 79%). Although only 13% of patients went onto salvage radical cystectomy, 9% also developed metastatic disease overall. The quality of evidence was poor, however, with only one randomized controlled trial and the remaining studies relying on single institution, single arm and retrospective studies
Conclusion:
Radiation therapy may offer some oncologic benefit for patients with high-risk NMIBC but the quality of evidence overall is poor. Further research is needed, especially a randomized trial, to critically evaluate its effectiveness in light of the continued national shortages of BCG
Funding: none
Image(s) (click to enlarge):
SYSTEMATIC REVIEW AND META-ANALYSIS OF RADIATION THERAPY FOR HIGH-RISK NON-MUSCLE INVASIVE BLADDER CANCER
Category
Bladder Cancer > Non-Muscle Invasive Bladder Cancer
Description
Poster #34
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Presented By: Rodrigo Rodrigues Pessoa
Authors:
Rodrigo Rodrigues Pessoa
Adam Mueller
Peter Boxley
Christi Piper
Thomas Flaig
Badrinath Konety
James Yu
Boris Gershman
Janet Kukreja
Simon Kim