A course of hypofractionated radiotherapy was associated with a lower risk of recurrence versus a longer course in patients with bladder cancer, according to a meta-analysis of 2 randomized phase 3 trials.1, 2
The results, published in the Oncology Lancet, showing that, at a median follow-up rate of 120 months, the hypofractionated schedule was associated with a 29% (HR, 0.71) lower risk of invasive locoregional recurrence compared with a longer radiotherapy regimen. The risk reduction was observed regardless of whether the patients were treated with chemotherapy in addition to radiotherapy, or radiotherapy alone.
The analysis also showed that 3-year-old locoregional invasive control was abnormal with hypofractionated radiotherapy, and the toxic profile was similar between the two treatment courses.
“This study provided a unique opportunity to use data from 2 randomized clinical trials to compare the two different radiotherapy tables used to treat invasive bladder cancer in the UK. Using statistically robust methods, we showed that the shortest course of radiotherapy was at least as good for patients as a whole and reduced the likelihood of a person’s cancer recurring after treatment, ”said co. study director Nuria Porta, PhD, chief statistician at the Cancer Research Institute, London, said in a press release.
“Not only is the shortest course more suitable for patients, but it also helps to keep people out of hospital for their own good and to free up NHS resources, which is very important during the routine pandemic, ”said Porta.
The analysis included data from 782 patients with locally advanced advanced bladder cancer enrolled in the BC2001 phase 3 trial (456 patients) or in the BCON phase 3 trial (326 patients). Among these patients, 376 received 64 Gy in 32 fractions over 6.5 weeks and 406 received the hypofractionated record of 55 Gy in 20 fractions over 4 weeks.
“Our study shows that people with bladder cancer get the same or even better results in a shorter course of radiotherapy delivered over four weeks, compared to the longer course over six weeks Shorter radiotherapy courses involving lower total radiation doses have already been proven to be just as effective in treating other types of cancer, including breast cancer and breast cancer. prostate cancer, higher dose options The new findings are an important step forward in providing patients with bladder cancer with a more gentle, tender treatment and are particularly timely The current Covid-19, where it is absolutely essential to keep patients out of hospital where possible, ”said study director Robert Huddart, PhD, professor of urological cancer at the Instit iud for Cancer Research, London, and consultant in Urological Oncology at the Royal Marsden NHS Foundation Trust, mentioned in the press release.
“We strongly recommend widespread use of the shortest course of radiotherapy for bladder cancer and believe it should be accepted as the new level of care for patients with the disease,” Huddart said.
References
1. A shorter course of radiotherapy reduces the risk of bladder cancer recurring. Published online February 2, 2021. Accessed February 2, 2021. https://bit.ly/39FBDCF.
2. Choudhury A, Porta N, Talla E, et al. Hypofractionated radiotherapy in local advanced bladder cancer: meta-analysis of individual patient data of the BC2001 and BCON tests. Lancet Oncol. 2021; 22 (2): 246-255. doi: 10.1016 / S1470-2045 (20) 30607-0