How do you approach muscle invasive bladder cancer in an elderly patient who cannot tolerate chemotherapy?
Do you favor a short palliative regimen, or a full course definitive treatment to 64.8Gy? How does your management change if the patient has a good performance status?
Answer from: Radiation Oncologist at Community Practice
Although the ideal approach is chemoRT, if patient can't tolerate chemo (if cisplatinum is contraindiacted, 5FU amd MMC is an alternative), then RT to a definitive dose is a reasonable alternative. In the UK randomised study, the control arm of RT alone had about 50% LRC at 2 yrs. For patients ...
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