Long-term followup of a bladder carcinoma cohort: Questionable value of radical radiotherapy

Purpose: We studied the outcome of radical radiotherapy for bladder carcinoma in all patients from a well-defined region. Materials and Methods: All 701 cases with a new bladder carcinoma between 1987 and 1988 in Western Sweden were prospectively documented and followed until 1994. Between 1987 and 1994, 74 of the 701 patients (mean age 73 years, range 54 to 88) were treated with external beam radiotherapy (60 Gy. or more). Results: At least 84% of the patients had persistent tumor, a local recurrence or a symptomatic contracted bladder after external beam radiotherapy. Seven patients (9.5%) died of early or late treatment related complications Of only 8 long-term survivors 6 had undergone radical transurethral resection before external beam radiotherapy. Conclusions: Full dose external beam radiotherapy in patients with bladder carcinoma was associated with high local recurrence and serious complication rates. It must be questioned whether elderly patients actually benefit from full dose radiotherapy.