Table 1. Risk of late Grade 3 or greater bladder toxicity in patients treated for bladder cancer in selected series not included in Marks et al. (1).
Investigator | Patients (n) | Simulation imaging | Total dose (Gy) | Whole-bladder dose (Gy) | Partial-bladder dose (Gy) | Fraction size (Gy) | Fractions (n) | EQD2 (Gy) | Late Grade ≥3 toxicity (%) |
---|---|---|---|---|---|---|---|---|---|
Duncan et al. (9)* | 889 | 2D | 55–57.5 | 55–57.5 | 2.75–2.88 | 20 | 60.2–63.8 | 17 | |
Moonen et al. (10)* | 15 | 3D | 66 | 66 | 2 | Last 8 b.i.d. | 66 | 0 | |
25 | 66 | 66 | 2 | Last 13 b.i.d. | 31 | ||||
Rödel et al.(11)* | 186* | 2D | 45–69.4 | 45–69.4 | 1.8–2 | 25–33 | 45–69.4 | 4y | |
Scholten et al. (12)* | 123 | 2D | 36 | 36 | 6 | 6 (2x/wk) | 54 | 0 | |
Mameghan et al. (13)* | 330 | 2D | 65 | 45–65 | 1.8–2.5 | 25–30 | 43.9– 69 | 2y | |
Perdona et al. (14)*‡ | 121 | 3D | 65 | 65 | 1.8 | 35 | 63.4 | 4y | |
Mangar et al. (15)* (CD) | 154 | 3D | 60–64 | 60–64 | — | 2 | 30–32 | 60–64 | 42 |
75 | 60–64 | 48–52 | 12 | 2 | 24–26 | 52/60–64 | 23 | ||
Cowan et al. (16)*§ | 25 | 3D | 52.5 | 52 | 2.63 | 20 | 56.3 | 4 | |
PB | 22 | 57.5 | 57.5 | 2.88 | 20 | 56.3–63.8 | 18 | ||
PB | 16 | 55 | 55 | 3.44 | 16 | 57.1–64.9 | 6 | ||
Yavuz et al. (17) (CD) | 87 | 3D | 45/67.5 | 45 | 22.5 | 1.8/1.5 CB | 35 | 43.9–65 | 1 |
Pos et al. (18) (CD) | 47 | 3D | 55 40 | 55 40 | — 15 | 2/2.75 CB | 20 | 40/55 | 9 |
Shipley et al. (19, 27) (CD) | 157 | 2D | 64–65 | 52–55 | 12–15 | 1.8/1.5–1.8 | 36–42 | 60.9–62.2 | 6 |
Abbreviations: EQD2 =equivalent dose in 2-Gy fractions, assuming α/β =6; 2D = two-dimensional conventional simulation; 3D =CT-based three-dimensional planning; b.i.d. = twice daily; PB = all treatment fields included only part of bladder, as determined by primary tumor site using CT-based planning; CD = first phase included whole bladder followed by cone down to partial bladder with CT-based planning; CB = concomitant boost; CT = computed tomography.
Treatment to the whole bladder as localized with contrast or CT.
Concurrent with chemotherapy.
Bladder in treatment fields; cone down from pelvic fields at median dose of 45 Gy.
Grade 2 or greater toxicity reported.