Radiation therapy for high-risk nonmuscle-invasive bladder cancer (NMIBC) may aid oncologic control, but distant progression still occurs, according to investigators presenting at SUO 2020, the virtual annual meeting of the Society of Urologic Oncology.

Rodrigo R. Pessoa, MD, PhD, of the University of Colorado in Aurora, Colorado and colleagues conducted a meta-analysis of 13 studies including 746 patients with high-grade T1 bladder cancer or T1/Ta with carcinoma in situ, multifocality, or diameter greater than 5 cm treated with primary radiation. Overall, the evidence was considered poor quality, with only 1 randomized controlled trial.

The recurrence-free survival rate was 54%. Cancer-specific and overall survival rates were 86% and 72%, respectively. Importantly, 13% of patients required salvage radical cystectomy, and metastatic disease developed in 9%.

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“Radiation therapy has been investigated as a possible treatment for high-risk NMIBC with the goal of bladder preservation, especially with the ongoing bacillus Calmette-Guerin (BCG) shortage,” Dr Pessoa explained. “In the setting of the low-quality evidence, a prospective clinical trial is needed to clearly define the risks and benefits of this approach.”


Pessoa RR, Mueller A, Boxley P, et al. Systematic review and meta-analysis of radiation therapy for high-risk nonmuscle invasive bladder cancer. Presented at: SUO 2020, December 3-5, 2020. Poster 34.