What is your preferred dose and fractionation for muscle invasive bladder cancer and how do you decide between them?

I'm using 5,500 cGy in 20 fractions since the Lancet Oncology meta-analysis. If I treat nodes, treat 4,400 cGy in the same 20 fractions. Seems like the mild-moderate toxicity might be higher than with 180-200 cGy/day regimen. The paper referenced above only assessed Grade 3 or higher toxicity. But t...

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.

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.

60 Gy/20 fractions with nodal coverage to 50 Gy/20 fractions with SIB, and concomitant weekly chemo-Cisplatin or Carboplatin.