A multi-institutional study of bladder-preserving therapy for stage II-IV bladder cancer: A Korean radiation oncology group study (KROG 14-16)

Sang Jun Byun, Won Park, Kwan Ho Cho, Jaeho Cho, Ah Ram Chang, Ki Mun Kang, Jin Ho Kim, Jin Hee Kim

Research output: Contribution to journalArticle

Abstract

Background Although radical cystectomy is a standard treatment in muscle-invasive bladder cancer, bladder preservation therapy including transurethral resection of bladder tumor, radiotherapy, and concurrent chemotherapy has been widely adopted, recently. This retrospective analysis was performed to evaluate the survival rates and prognostic factors related to treatment outcomes following bladder-preserving therapy including radiotherapy (RT) in bladder cancer with a curative intent. Materials and methods We conducted a multi-institutional retrospective study of 152 patients with stage II-IV bladder cancer treated with curative RT between 2000 and 2010. There were 72 patients in stage II, 49 in stage III, and 31 in stage IV. Ninety-seven patients were treated with concurrent chemoradiotherapy and fifty-five with RT alone. Radiation was delivered to the pelvis (median 63 Gy), mainly with cisplatin. The median follow-up time was 35.5 months. Results Sixty-nine patients (45.4%) showed a complete response to RT. The 5-year overall survival (OS) rate was 45.8%, the 5-year cause-specific survival (CSS) rate was 48.9%, and the 5-year disease-free survival (DFS) rate was 20.8%. Univariate analysis revealed significant differences in the following factors according to the survival rates: patient age, initial hemoglobin level, clinical T stage, clinical N stage, clinical stage group, tumor response to RT, hydronephrosis, and concurrent chemotherapy. Multivariate analysis also revealed a significant difference in patient age (p = 0.003 in OS, p<0.017 in CSS) and tumor response to RT (p = 0.002 in OS, p<0.001 in CSS). Concurrent chemotherapy was significantly different in the DFS rates (p = 0.046). Conclusions The survival rates reported herein are comparable to those from other studies, and tumor response and concurrent chemoradiotherapy were significant prognostic factors for better survival rates. Further randomized studies are needed to elucidate the impact of RT in bladder cancer.

Original languageEnglish
Article numbere0209998
JournalPloS one
Volume14
Issue number1
DOIs
Publication statusPublished - 2019 Jan

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Radiation Oncology
Oncology
Radiotherapy
radiotherapy
bladder
Urinary Bladder Neoplasms
Urinary Bladder
Survival Rate
survival rate
Radiation
therapeutics
Chemotherapy
Chemoradiotherapy
Tumors
drug therapy
Survival
Therapeutics
Drug Therapy
Disease-Free Survival
neoplasms

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

Byun, Sang Jun ; Park, Won ; Cho, Kwan Ho ; Cho, Jaeho ; Chang, Ah Ram ; Kang, Ki Mun ; Kim, Jin Ho ; Kim, Jin Hee. / A multi-institutional study of bladder-preserving therapy for stage II-IV bladder cancer : A Korean radiation oncology group study (KROG 14-16). In: PloS one. 2019 ; Vol. 14, No. 1.
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title = "A multi-institutional study of bladder-preserving therapy for stage II-IV bladder cancer: A Korean radiation oncology group study (KROG 14-16)",
abstract = "Background Although radical cystectomy is a standard treatment in muscle-invasive bladder cancer, bladder preservation therapy including transurethral resection of bladder tumor, radiotherapy, and concurrent chemotherapy has been widely adopted, recently. This retrospective analysis was performed to evaluate the survival rates and prognostic factors related to treatment outcomes following bladder-preserving therapy including radiotherapy (RT) in bladder cancer with a curative intent. Materials and methods We conducted a multi-institutional retrospective study of 152 patients with stage II-IV bladder cancer treated with curative RT between 2000 and 2010. There were 72 patients in stage II, 49 in stage III, and 31 in stage IV. Ninety-seven patients were treated with concurrent chemoradiotherapy and fifty-five with RT alone. Radiation was delivered to the pelvis (median 63 Gy), mainly with cisplatin. The median follow-up time was 35.5 months. Results Sixty-nine patients (45.4{\%}) showed a complete response to RT. The 5-year overall survival (OS) rate was 45.8{\%}, the 5-year cause-specific survival (CSS) rate was 48.9{\%}, and the 5-year disease-free survival (DFS) rate was 20.8{\%}. Univariate analysis revealed significant differences in the following factors according to the survival rates: patient age, initial hemoglobin level, clinical T stage, clinical N stage, clinical stage group, tumor response to RT, hydronephrosis, and concurrent chemotherapy. Multivariate analysis also revealed a significant difference in patient age (p = 0.003 in OS, p<0.017 in CSS) and tumor response to RT (p = 0.002 in OS, p<0.001 in CSS). Concurrent chemotherapy was significantly different in the DFS rates (p = 0.046). Conclusions The survival rates reported herein are comparable to those from other studies, and tumor response and concurrent chemoradiotherapy were significant prognostic factors for better survival rates. Further randomized studies are needed to elucidate the impact of RT in bladder cancer.",
author = "Byun, {Sang Jun} and Won Park and Cho, {Kwan Ho} and Jaeho Cho and Chang, {Ah Ram} and Kang, {Ki Mun} and Kim, {Jin Ho} and Kim, {Jin Hee}",
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A multi-institutional study of bladder-preserving therapy for stage II-IV bladder cancer : A Korean radiation oncology group study (KROG 14-16). / Byun, Sang Jun; Park, Won; Cho, Kwan Ho; Cho, Jaeho; Chang, Ah Ram; Kang, Ki Mun; Kim, Jin Ho; Kim, Jin Hee.

In: PloS one, Vol. 14, No. 1, e0209998, 01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A multi-institutional study of bladder-preserving therapy for stage II-IV bladder cancer

T2 - A Korean radiation oncology group study (KROG 14-16)

AU - Byun, Sang Jun

AU - Park, Won

AU - Cho, Kwan Ho

AU - Cho, Jaeho

AU - Chang, Ah Ram

AU - Kang, Ki Mun

AU - Kim, Jin Ho

AU - Kim, Jin Hee

PY - 2019/1

Y1 - 2019/1

N2 - Background Although radical cystectomy is a standard treatment in muscle-invasive bladder cancer, bladder preservation therapy including transurethral resection of bladder tumor, radiotherapy, and concurrent chemotherapy has been widely adopted, recently. This retrospective analysis was performed to evaluate the survival rates and prognostic factors related to treatment outcomes following bladder-preserving therapy including radiotherapy (RT) in bladder cancer with a curative intent. Materials and methods We conducted a multi-institutional retrospective study of 152 patients with stage II-IV bladder cancer treated with curative RT between 2000 and 2010. There were 72 patients in stage II, 49 in stage III, and 31 in stage IV. Ninety-seven patients were treated with concurrent chemoradiotherapy and fifty-five with RT alone. Radiation was delivered to the pelvis (median 63 Gy), mainly with cisplatin. The median follow-up time was 35.5 months. Results Sixty-nine patients (45.4%) showed a complete response to RT. The 5-year overall survival (OS) rate was 45.8%, the 5-year cause-specific survival (CSS) rate was 48.9%, and the 5-year disease-free survival (DFS) rate was 20.8%. Univariate analysis revealed significant differences in the following factors according to the survival rates: patient age, initial hemoglobin level, clinical T stage, clinical N stage, clinical stage group, tumor response to RT, hydronephrosis, and concurrent chemotherapy. Multivariate analysis also revealed a significant difference in patient age (p = 0.003 in OS, p<0.017 in CSS) and tumor response to RT (p = 0.002 in OS, p<0.001 in CSS). Concurrent chemotherapy was significantly different in the DFS rates (p = 0.046). Conclusions The survival rates reported herein are comparable to those from other studies, and tumor response and concurrent chemoradiotherapy were significant prognostic factors for better survival rates. Further randomized studies are needed to elucidate the impact of RT in bladder cancer.

AB - Background Although radical cystectomy is a standard treatment in muscle-invasive bladder cancer, bladder preservation therapy including transurethral resection of bladder tumor, radiotherapy, and concurrent chemotherapy has been widely adopted, recently. This retrospective analysis was performed to evaluate the survival rates and prognostic factors related to treatment outcomes following bladder-preserving therapy including radiotherapy (RT) in bladder cancer with a curative intent. Materials and methods We conducted a multi-institutional retrospective study of 152 patients with stage II-IV bladder cancer treated with curative RT between 2000 and 2010. There were 72 patients in stage II, 49 in stage III, and 31 in stage IV. Ninety-seven patients were treated with concurrent chemoradiotherapy and fifty-five with RT alone. Radiation was delivered to the pelvis (median 63 Gy), mainly with cisplatin. The median follow-up time was 35.5 months. Results Sixty-nine patients (45.4%) showed a complete response to RT. The 5-year overall survival (OS) rate was 45.8%, the 5-year cause-specific survival (CSS) rate was 48.9%, and the 5-year disease-free survival (DFS) rate was 20.8%. Univariate analysis revealed significant differences in the following factors according to the survival rates: patient age, initial hemoglobin level, clinical T stage, clinical N stage, clinical stage group, tumor response to RT, hydronephrosis, and concurrent chemotherapy. Multivariate analysis also revealed a significant difference in patient age (p = 0.003 in OS, p<0.017 in CSS) and tumor response to RT (p = 0.002 in OS, p<0.001 in CSS). Concurrent chemotherapy was significantly different in the DFS rates (p = 0.046). Conclusions The survival rates reported herein are comparable to those from other studies, and tumor response and concurrent chemoradiotherapy were significant prognostic factors for better survival rates. Further randomized studies are needed to elucidate the impact of RT in bladder cancer.

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