Abstract
Background
We report outcomes of a retrospective, single-institution experience with consolidative
radiation after chemotherapy in metastatic urothelial cancer (MUC).
Patients and Methods
From our single-institution database of 2597 patients with urothelial carcinoma treated
since 1997, we identified 22 patients with MUC who underwent consolidative radiotherapy
after a partial response to chemotherapy with the intent of rendering them disease-free.
All patients had undergone primary surgical therapy with either cystectomy or nephroureterectomy.
Progression-free survival (PFS) was defined as time from completion of radiation therapy
to relapse or last follow-up. Overall survival (OS) was defined as time from start
of chemotherapy to death or last follow-up.
Results
In the selected group of patients with MUC, the median age was 67 years; 59% had received
previous cisplatin-based chemotherapy. The most common sites radiated were the regional
lymph nodes (64%). Other radiated sites included the lung, adrenal glands, and omental
metastases. Median survival from diagnosis to cystectomy was 48 months. Median PFS
was 13 months and median OS was 29 months. Eight patients (36%) were alive and disease-free
6 years after radiation therapy. Patients who were rendered disease-free were those
with nodal metastases and delivery of radiation to a single site of metastasis.
Conclusion
In this highly selective cohort of patients with MUC treated with consolidative radiation
after chemotherapy, 36% were rendered disease-free. This suggests that radiation is
feasible and might contribute to long-term disease control. Further prospective studies
are needed to better characterize the benefit of combined modality treatment.
Keywords
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Article info
Publication history
Published online: April 13, 2017
Accepted:
April 3,
2017
Received in revised form:
March 24,
2017
Received:
January 4,
2017
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
