What is your preferred dose and fractionation for muscle invasive bladder cancer and how do you decide between them?
What patient factors do you consider to decide between 55 Gy/20 fx and 64 Gy/32 fx with or without nodal irradiation? What if your patient is younger or older?
Answer from: Radiation Oncologist at Community Practice
The question lacks specificity and forces a dogmatic answer. There are so many scenarios where I would treat the nodes, I may escalate the bladder, or even use a plan of the day. Performance status, use of chemo, presence of variant, histology, anatomy, etc., etc.
Comments
Radiation Oncologist at University of Texas at Tyler
Recall that the choice of radiation was not random...
Recall that the choice of radiation was not random...
Answer from: Radiation Oncologist at Academic Institution
If cN0, 55 Gy in 2 0Fx, entire bladder, simmed and treated empty, no cone down. No nodal RT.
If cN1, then I'd probably try to take nodes to higher than 55 Gy in 20 Fx as feasible and consider 44 in 20 ENI.
Answer from: Radiation Oncologist at Community Practice
60 Gy/20 fractions with nodal coverage to 50 Gy/20 fractions with SIB, and concomitant weekly chemo-Cisplatin or Carboplatin.
Comments
Radiation Oncologist at Iowa City Cancer Treatment Center
The question should be readdressed with more infor...
The question should be readdressed with more infor...
Radiation Oncologist at Providence Health, St. Joseph Hospital
Do you cone down to the whole bladder, or partial ...
Do you cone down to the whole bladder, or partial ...
Radiation Oncologist at Kansas City VA Medical Center
If there is a definable mass seen on the diagnosti...
If there is a definable mass seen on the diagnosti...
Radiation Oncologist at University of Michigan
Interesting. You use 60 Gy in 20 fx to whole bladd...
Interesting. You use 60 Gy in 20 fx to whole bladd...
Radiation Oncologist
Can you cite published data to support this approa...
Can you cite published data to support this approa...
Radiation Oncologist at Lafayette Radiation Center
66 and 20 are over the BED with a/b 3 in NCT011246...
66 and 20 are over the BED with a/b 3 in NCT011246...
Do you deliver this whole bladder, treated with an...
Yes, whole bladder; empty; no cone down.
So meta-analysis is the new standard for picking r...
The paper I am referring to is better than some me...