Abstract 294P
Background
To assess the outcomes and tolerance of definitive chemoradiotherapy (CRT) for muscle invasive bladder cancer (MIBC) in elderly patients.
Methods
We retrospectively reviewed elderly patients aged 70 years and above treated with curative CRT for MIBC between March 2019 to February 2023. Patterns of recurrence and treatment-related toxicities were assessed. Acute and late toxicities were evaluated according to the Common Terminology Criteria for Adverse Events v5.0. Complete response (CR) was defined as no evidence of tumor at 3 months follow-up after CRT. Survival outcomes were estimated using the Kaplan-Meier method.
Results
We identified 23 patients (16 males, 7 females) with a median age of 80 years (range 72–89). Median follow-up was 20 months (range 11–49 months). All patients received 60 Gy in 30 fractions with concurrent cisplatin-based chemotherapy and completed the planned treatment. A total of 19 (82.6%) patients had T2 disease, 22 patients (95.7%) had urothelial carcinoma histology, and 3 patients (13%) received neoadjuvant chemotherapy. 95.7% (n=22) of patients achieved a CR. 10 of 23 patients (43.5%) developed a loco-regional recurrence, either in the bladder (n=10) or pelvic lymph nodes (n=1). 3 patients (13%) developed distant metastases, 2 of these were fit for palliative chemotherapy. The median OS was 39 months (range 13–50 months), and the overall 2-year survival rate was 77.3%. The mean PFS was 24 months (95% confidence interval: 19–30 months) and no median was reached, and the 2-year PFS was 50.8%. No significant differences were found in OS and PFS according to the T stage, N stage or maximal transuretral resection of the bladder. The most common grade ≤ 2 gastrointestinal and genitourinary (GU) toxicities were diarrhea and radiation cystitis. Grade 3 GU toxicity occurred in 2 patients (n=1, urinary tract infection during CRT; n=1, hematuria controlled by embolization at 12 months after completion of CRT, respectively).
Conclusions
Our results show that CRT-based bladder-sparing for MIBC is feasible with acceptable toxicity in elderly (≥ 70 years) patients. Further prospective studies are needed to confirm these results.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.