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Interstitial iridium-192 for bladder cancer (a multicentric survey: 205 patients).
- Source :
-
International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 1992; Vol. 24 (3), pp. 469-77. - Publication Year :
- 1992
-
Abstract
- Interstitial irradiation is a technique currently used in the treatment of bladder cancer. We report the data on 205 patients (177 men and 28 women) treated in eight French centers. The patients had received the following treatment: a short course of pre-operative pelvic irradiation, followed by surgery consisting of partial cystectomy or tumor resection, and implantation of plastic tubes filled with inactive lead wires, which were replaced by iridium 192 wires. The tumor characteristics were: transitional cell carcinoma, 88.8%; mean size of the tumor, 29 mm; pathological stages: pTis, 1; pT1, 98; pT2, 66; pT3a, 26; pT3b, 9; pT4, 1; unknown, 4 respectively; surgical lymph node status: N+, 3; N-, 118; no node dissection, 84. The mean follow-up was 51 months. Intravesical failures were seen in 35 patients (17.0%), 25 (71.4%) of them without metastases or regional recurrences. Twenty-one patients (10.2%) presented distant metastases, 2/3 of them suffered no bladder relapse. The 5-year survival, calculated according to the Kaplan-Meier method (all causes of death taken together) was 77.4% for the T1, 62.9% for the T2, and 46.8% for the T3. Fifty-three patients had immediate side-effects and three died from surgical complications. Twenty-nine patients had delayed bladder side-effects (haematuria, fistula, chronic cystitis). Six patients presented an ureteral stenosis. Of the disease-free survivors, 96.1% retained the bladder function. Three factors were significantly predictive of delayed side-effects: partial cystectomy, pre-operative radiotherapy total dose, and linear activity of the wires (p < 0.01). Comparing our results to different authors' series interstitial irradiation is likely to provide a high local and general control of the disease and good quality of life in patients with selected tumors.
- Subjects :
- Adenocarcinoma epidemiology
Adenocarcinoma surgery
Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell epidemiology
Carcinoma, Squamous Cell surgery
Carcinoma, Transitional Cell epidemiology
Carcinoma, Transitional Cell surgery
Combined Modality Therapy
Female
Follow-Up Studies
France epidemiology
Humans
Male
Middle Aged
Neoplasm Recurrence, Local epidemiology
Retrospective Studies
Survival Rate
Urinary Bladder Neoplasms epidemiology
Urinary Bladder Neoplasms surgery
Adenocarcinoma radiotherapy
Brachytherapy
Carcinoma, Squamous Cell radiotherapy
Carcinoma, Transitional Cell radiotherapy
Iridium Radioisotopes therapeutic use
Urinary Bladder Neoplasms radiotherapy
Subjects
Details
- Language :
- English
- ISSN :
- 0360-3016
- Volume :
- 24
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- International journal of radiation oncology, biology, physics
- Publication Type :
- Academic Journal
- Accession number :
- 1399732
- Full Text :
- https://doi.org/10.1016/0360-3016(92)91061-q