Neobladder and ablative pelvic radiotherapy: still a taboo?

2021 ◽  
pp. 030089162110312
Author(s):  
Luca Bergamaschi ◽  
Marianna Alessandra Gerardi ◽  
Mattia Zaffaroni ◽  
Matteo Augugliaro ◽  
Sabrina Vigorito ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Pelvic Recurrence ◽  
Response To Treatment ◽  
Postoperative Treatment ◽  
Radiation Oncologist ◽  
Pelvic Radiotherapy

The presence of a neobladder constitutes a limitation for the radiation oncologist, as there is no clear evidence about its tolerance to radiotherapy (RT). The limited literature only concerns the conventional postoperative treatment in patients with bladder cancer after cystectomy. Here we report a case of a patient with neobladder who underwent a stereotactic RT for a pelvic recurrence of disease, with response to treatment and no toxicity to the neobladder. This case represents a promising example of the chance to perform RT with ablative intent, using advanced techniques, even on lesions close to the neobladder.

MP61-20 PELVIC RECURRENCE FOLLOWING RADICAL CYSTECTOMY AND ITS IMPACT ON BLADDER CANCER OUTCOMES

2014 ◽  
Vol 191 (4S) ◽  
Author(s):  
Anirban P. Mitra ◽  
Anne K. Schuckman ◽  
Eila C. Skinner ◽  
Siamak Daneshmand
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Pelvic Recurrence ◽  
Cancer Outcomes

The efficacy of trimodal chemoradiotherapy with gemcitabine and cisplatin as a bladder-preserving strategy for the treatment of muscle invasive bladder cancer: A single-arm prospective study.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 516-516
Author(s):  
Hiroaki Matsumoto ◽  
Kazuhiro Nagao ◽  
Sho Ozawa ◽  
Masahiro Samoto ◽  
Junichi Mori ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Clinical Stage ◽  
Good Prognosis ◽  
Response To Treatment ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Bladder Preservation ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Muscle Invasive

516 Background: Radical cystectomy is still the standard treatment for muscle-invasive bladder cancer (MIBC), while the patients with MIBC are not always appropriate candidates due to multiple comorbidities. We establish novel treatment strategy by trimodal treatment. Methods: The regimen was gemcitabine 300 mg/m2, and cisplatin 30mg/m2 in day 1 and concomitant irradiation 2Gy/Fr, 5 fraction per week. Irradiation was administered to whole pelvis up to 30Gy, then boost to true pelvis until total 48Gy to 54Gy. Extensive transurethral resection (TURBT) was performed and we confirmed pathological stage ≥T2. TURBT was also performed after chemoradiotherapy to evaluate the pathological response to treatment. This study was approved in our institutional review board (ID: H23-89) and the information was opened on UMIN (ID: UMIN000006363). We analyzed their treatment efficacy and survival. Results: The patients were 29 men and 9 women, median age was 76.5 y.o. and median follow up was 23 months (1 - 112). Clinical stage T2, T3, T4, N1 and N2 were 23, 10, 5, 4, 2 cases, respectively. The 2- and 5-year metastatic-free survival (MFS), bladder-recurrence free survival (bRFS), cancer-specific survival (CSS), and overall survival (OS) rates after treatment were 91.7 and 84.0%, 59.7 and 42.6%, 87.3 and 87.3%, and 87.3 and 81.8%, respectively. Salvage cystectomy was performed 3 patients and they were still alive. CR rate was 78.9% and overall response rate was 92.1%. cT stage and valiant histology was not associated with treatment response. The patients achieved CR had significant good prognosis in CSS (p=0.0149) and OS (p=0.0149) compared with non-responders. In cox hazard model, CR achievement was significant prognostic factors for OS (p =0.0015, HR 6.804e+26, 95% CI 56.94-1.631e+86). Patients were able to receive 3 to 5 cycle GC radiation and any grade 3 or more adverse event was 7 (18.4%) cases. no treatment related death was recorded. Conclusions: In selected patients, GC radiation for MIBC may provide good oncological outcomes as bladder preservation strategy.

scholarly journals Sexual Concerns after (Pelvic) Radiotherapy: Is There Any Role for the Radiation Oncologist?

2015 ◽  
Vol 12 (9) ◽  
pp. 1927-1939 ◽  
Author(s):  
Esmée M. Krouwel ◽  
Melianthe P. Nicolai ◽  
Gerard J. van der Wielen ◽  
Hein Putter ◽  
Augustinus D.G. Krol ◽  
...  
Keyword(s):  
Radiation Oncologist ◽  
Pelvic Radiotherapy ◽  
Sexual Concerns

Relationship between neutrophils/lymphocytes and tumor infiltrating lymphocytes stroma in patients with invasive muscle bladder cancer and the response to treatment.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16513-e16513
Author(s):  
Martin Eduardo Richardet ◽  
Maria gimena Ferreira ◽  
Martin Paradelo ◽  
Luciana Paola Acosta ◽  
Matias Molina ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Predictive Factor ◽  
Objective Response ◽  
Neoadjuvant Treatment ◽  
High Body Mass Index ◽  
Response To Treatment ◽  
Number Of Patients ◽  
The Difference ◽  
Tract Infections ◽  
Infiltrating Lymphocytes

e16513 Background: The bladder cancer is a malignant disease. It has been related to tobacco consumption, fat diet, high body mass index (BMI) and urinary tract infections. As a result of the activation the pro-inflammatory pathways. Neutrophil to lymphocyte radio (NLR) and the infiltrating lymphocytes of the tumor stroma (TILs) have been shown to have a significant prognostic value in different tumors. The primary aim is to analyze the role of TILs and RNL as a predictive factor, in patients with MIBC and objective response rate (ORR). The secondary aim is to evaluate the relationship beteween BMI, tabaquism and ORR, in the same group of pts. Methods: A total of 35 pts with MIBC was included. All pts received neoadjuvant treatment, with cisplatin and gemcitabine. Also, TILs was determined as the percentage of mononuclear inflammatory cells in the total stromal area counted in 5 high-power fields (CGA, X 400), on the invasive front of the tumor. The NLR was obtained before treatment and value of cut-off was 2.6. the evaluation of ORR was calculated used the T-Test and Chi Square test. Results: Of the total of 35 patients. 15 patients obtained complete response (CR), 6 pts partial response (PR), 5 pts stable disease (SD) and 9 pts disease progression (DP). In 21 tumor sample was observed an intense TILS. These patients obtained a better ORR 42.6 % vs 21.7% with low TILs in his tumor samples. The difference was statistically significant (p: 0.001). Regarding NLR, only 9 pts presented response with NLR > 2,6 vs 12 pts with response and RNL < 2.6. The difference was not statistically significant. When analyzing the smoking and response. We could observe response of 69.6% in smoking pts vs Non- smoking the response was 41.7%. Regarding BMI, 21 pts with response of 27% and 14 patient without response 25.9%. But the differences were not significant in any groups. Conclusions: We conclude that the presence of TILS in tumor samples, in patients with MIBC, could be a predictive factor against the response to neoadjuvant treatment. With the other variables, smoking and BMI, we did not observed influence in ORR. We will keep working to obtain a greater number of patients. Then we could have a better analysis and statistical power.

scholarly journals EP-1386: Adjuvant pelvic radiotherapy for pathological high-risk muscle-invasive bladder cancer

2016 ◽  
Vol 119 ◽  
pp. S647
Author(s):  
P. Sargos ◽  
I. Latorzeff ◽  
A. Fléchon ◽  
G. Roubaud ◽  
V. Brouste ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Invasive Bladder Cancer ◽  
Pelvic Radiotherapy ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

scholarly journals When the Treatment is the Cause: Disseminated Bacille Calmette–Guérin Infection

2020 ◽  
Author(s):  
Ana Teresa Marques Afonso ◽  
Montserrat Rodríguez Framil ◽  
Joaquín Sánchez Leira ◽  
Néstor Vázquez Agra ◽  
Federico García-Rodeja Arias
Keyword(s):  
Computed Tomography ◽  
Weight Loss ◽  
Bladder Cancer ◽  
Clinical Response ◽  
Superficial Bladder Cancer ◽  
Response To Treatment ◽  
Bacille Calmette Guerin ◽  
Systemic Complications ◽  
Computed Tomography Scanning ◽  
Tomography Scanning

Bacille Calmette–Guérin (BCG) administration for superficial bladder cancer is a well-tolerated and very effective therapy. However, unpredictable systemic complications may occur on rare occasions. We present the case of a patient who attended for consultation because of fever, asthenia and weight loss following BCG immunotherapy. The clinical response to treatment and computed tomography scanning were key to diagnosis.

Circulating cellular biomarkers associated with delayed time to progression among bladder cancer patients treated with immune checkpoint inhibitors.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 398-398
Author(s):  
Vadim S Koshkin ◽  
Terence W. Friedlander ◽  
Patricia Li ◽  
Joseph Schonhoft ◽  
Rachel Krupa ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cancer Patients ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Significant Trend ◽  
Response To Treatment ◽  
Time To Progression ◽  
Metastatic Bladder Cancer ◽  
Delayed Time

398 Background: Circulating tumor cells (CTCs) are an important emerging biomarker in bladder cancer that allow for a minimally invasive assessment of tumor activity and response to treatment. Characterization of CTC and other single cell populations associated with improved clinical outcomes can help guide treatment recommendations for patients with metastatic bladder cancer. Methods: Patients with metastatic bladder cancer who received treatment with anti-PD-1 or anti-PD-L1 agents were enrolled in this study. Patient response to treatment was assessed by treating physicians according to RECIST v1.1. Blood samples were prospectively collected from patients prior to the initiation of therapy and then while on treatment and shipped to Epic Sciences for processing. All nucleated cells were subjected to immunofluorescent (IF) staining and CTC and leukocyte identification by fluorescent scanners using algorithmic analysis. Kaplan-Meier analysis was utilized to compare time to progression of patients whose CTC and leukocyte values were above and below several pre-determined parameters. Results: A total of 27 patients (median age 74 years, 70% male) were enrolled in this study and were treated with anti-PD-1/PD-L1 agents pembrolizumab (n=15), atezolizumab (n=11), or nivolumab (n=1). For 20 patients who had evaluable responses, objective response rate (ORR) was 2/20 (10%), all partial responses; another 5/20 (35%) had stable disease. Increased CD4% (>8% of total leukocytes) was associated with delayed time to progression (TTP) (p=0.002) whereas increased baseline total CTCs (>2) had a statistically non-significant trend towards shorter TTP (p=0.09). Baseline CD8%, CD4/CD8 ratio and CTC PD-L1 status were not associated with TTP. Conclusions: In a preliminary analysis among metastatic bladder cancer patients treated with immune checkpoint inhibitors, patients with an increased baseline CTC count had a statistically non-significant trend towards shorter TTP whereas increased baseline CD4 cells had an association with delayed TTP. This prospective study is ongoing, and the results will be further validated in larger patient cohorts.

Sign in / Sign up

Export Citation Format

Share Document