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The role of palliative radiotherapy in the management of elderly and frail patients with advanced bladder cancer: A survey by the AIRO uro-group.

Authors :
Marvaso G
Nicosia L
Vinciguerra A
Borghetti P
Trodella LE
Francolini G
Timon G
Matrone F
Ognibene L
Franzese C
Jereczek-Fossa BA
Arcangeli S
Source :
Medical oncology (Northwood, London, England) [Med Oncol] 2021 Jan 23; Vol. 38 (2), pp. 14. Date of Electronic Publication: 2021 Jan 23.
Publication Year :
2021

Abstract

Radiotherapy (RT) is rarely used in the palliative management of muscle-invasive bladder cancer (MIBC). This survey aims to explore current care patterns within the Italian Radiation Oncologist community on this topic. In 2020, the uro-oncological study group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) conducted a survey evaluating the RT role in advanced MIBC. An electronic questionnaire was administered online to the society members asking for: general considerations, patients' selection, and aim of the treatment, RT schedule and practical consideration, past and future perspective. Sixty-one questionnaires were returned (33% response rate). Most responders (62.30%) declared to work in a Center with a multidisciplinary uro-oncological team, and 8.20% to evaluate more than 20 patients with MIBC/year for palliative RT. Elderly patients were the most frequently evaluated (46.7%) and life expectancy was the most common selection criteria (44.60%). Thirty Gy in 10 fractions (58.9%), whole bladder as GTV (62.5%), PTV isotropic margins of 1.5-2 cm (44.6%) and IMRT/VMAT technique (58.14%) were the most common treatment choices. Patients amenable for bladder palliative RT were most commonly referred by the urologist (43.86%) or the multidisciplinary team (38%). The reported main reasons for the low involvement of radiation oncologist in the management of MIBC patients were low attention to the palliative setting in bladder cancer (37.5%); radiation oncologist not involved in the management of these patients (32.1%); cases not discussed in the multidisciplinary board (26.8%). This survey illustrated the current use of palliative RT for patients with advanced MIBC in Italy and suggested the need for a greater involvement of radiation oncologists in their management.

Details

Language :
English
ISSN :
1559-131X
Volume :
38
Issue :
2
Database :
MEDLINE
Journal :
Medical oncology (Northwood, London, England)
Publication Type :
Academic Journal
Accession number :
33484363
Full Text :
https://doi.org/10.1007/s12032-021-01455-4