Abstract
Background
The present retrospective study analyzed the tolerance of orthotopic ileal neobladders
to radiotherapy by reviewing the acute and late toxicity in patients who underwent
postoperative radiotherapy after radical cystectomy/cystoprostatectomy.
Materials and Methods
A multi-institutional database was created for patients who had undergone radical
cystectomy/cystoprostatectomy and neobladder reconstruction, followed by adjuvant
radiotherapy (RT). The patient and tumor characteristics were recorded. The RT data
were reviewed to determine the treatment technique used, the radiation dose received
by the neobladder, and acute and late toxicity evaluated using the Common Terminology
Criteria for Adverse Events, version 4.0, scale.
Results
A total of 25 patients were included, with a median age of 64 years. Of the 25 patients,
18 received a dose of 45 to 50.4 Gy. The most common reasons for postoperative radiotherapy
were close or positive surgical margins and pT3-pT4 or N+ disease. Ten patients underwent
intensity modulated RT. All but 1 patient completed the RT course. Of the patients
who completed their RT schedule, none had grade ≥ 3 acute gastrointestinal toxicity.
One patient who received concurrent chemotherapy developed grade 3 acute genitourinary
toxicity. Three patients reported late grade 1 genitourinary toxicity (frequency of
urination, mild leakage at night), with no reports of chronic gastrointestinal toxicity.
None of the patients experienced neobladder perforation, leak, or fistula.
Conclusion
The use of moderate doses of pelvic RT (range, 45-50.4 Gy) was well tolerated among
the 25 patients who underwent RT after cystoprostatectomy with orthotopic neobladder
creation. This finding supports the use of postoperative RT to moderate doses in this
patient population when clinically indicated.
Keywords
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Article info
Publication history
Published online: May 09, 2017
Accepted:
May 1,
2017
Received in revised form:
April 21,
2017
Received:
January 20,
2017
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
