When would you recommend adjuvant radiation following cystectomy for urothelial bladder cancer?
Would you offer it for positive margins? NCCN says to consider adjuvant radiation for pT3-T4 or pN0-2. Is there sufficient evidence for adjuvant radiation in bladder cancer?
Answer from: Radiation Oncologist at Academic Institution
Local-regional recurrence for patients with ≥pT3 disease after radical cystectomy is a significant problem (1) and warrants consideration of adjuvant radiation therapy in patients who are likely to tolerate such treatment. Chemotherapy has not been shown to reduce the risk of local...
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Answer from: Radiation Oncologist at Academic Institution
There is sound rationale (1), and some clinical trial evidence, to administer post-operative radiation after cystectomy. Local recurrences do occur after cystectomy for locally advanced bladder cancer. In a patterns of failure analysis from our institution (2), we discovered a >30% rate of local-...