Christodoulou, M, Reeves, KJ, Hodgson, C et al. (6 more authors) (2018) Outcomes of radiosensitisation in elderly patients with advanced bladder cancer. Radiotherapy and Oncology, 129 (3). pp. 499-506. ISSN 0167-8140
Abstract
Introduction: There is little evidence to guide treatment in elderly patients with muscle invasive bladder cancer (MIBC). We evaluated the efficacy and tolerability of concurrent radical radiotherapy with gemcitabine radiosensitisation (GemX) in elderly patients with MIBC and compared outcomes to those from the bladder carbogen and nicotinamide (BCON) phase III trial. Materials and methods: Data were retrospectively analysed for patients who received GemX from two oncology centres in the UK. Elderly was defined as aged ≥75 at the start of GemX. Following transurethral resection of bladder tumour, patients received neo-adjuvant platinum-based chemotherapy followed by radiotherapy concurrently with weekly gemcitabine. A separate, age-specific analysis was performed in the BCON cohort. Overall survival (OS), disease specific survival (DSS) and local progression free survival (LPFS) were evaluated using Kaplan–Meier methodology and Cox proportional hazards regression. Results: Out of 167 patients who received GemX, 61 were elderly (36.5%) with a median age of 78 years. Elderly patients had worse performance status (p = 0.020) and co-morbidities (p = 0.030). A similar proportion of patients received planned dose radiotherapy in both groups (p = 0.260), although fewer elderly patients received all four cycles of concurrent chemotherapy (p = 0.017) due to toxicity. For OS, age had some prognostic power; HR 1.04 (95% CI 1.00–1.08; p = 0.068). Overall survival and LPFS in elderly patients were comparable between CON and GemX (HR 1.13, 95% CI 0.69–1.85; p = 0.616 and HR 0.85, 95% CI 0.41–1.74; p = 0.659 respectively). Discussion: Radiosensitisation is safe and effective and should be considered for fit elderly patients with MIBC.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | Crown Copyright © 2018 Published by Elsevier B.V. All rights reserved. This is an author produced version of a paper published in Radiotherapy and Oncology. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Muscle invasive bladder cancer; Radiotherapy; Elderly; Radiosensitisation |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cancer and Pathology (LICAP) > Clinical Cancer Research (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 06 Jul 2018 09:29 |
Last Modified: | 02 Jun 2019 00:39 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.radonc.2018.05.022 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:132966 |
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