Safety of volumetric modulated arc therapy in elderly patients with bladder cancer
Objective:To evaluate the safety and symptoms response rate(SRR)of volumetric modulated arc therapy(VMAT)alone in elderly patients with bladder cancer.Methods:Patients with bladder cancer were col-lected from May 2019 to July 2023 who admitted to the department of radiation oncology in Peking University First Hospital.According to the inclusion and exclusion criteria,46 patients with bladder cancer were included in the final analysis.The clinical characteristics of the patients were collected,including age,gender,pathological type,TNM stage,radiation dose and volume.The patients were also followed up to collect information on treat ment-related side effects and symptoms response.Results:The median age of 46 patients was 85(74-94)years old.The pathologic type of uroepithelial carcinoma was found in 93.7％of the patients,and ≥T3 accounted for 67.4％.All patients received VMAT and daily CBCT image guided radiation therapy.The acute and late side effects were genitourinary(GU)toxicities.The incidence of ≥G3 acute GU toxicity was 6.5％,and urine burning was common.The incidence of ≥G3 late GU toxicity was 10.8％including one vesical fistula,and severe hema-turia and painful urination were common.The overall SRR was 80.4％,and hematuria-free rate was 94.3％.Conclusion:VMAT may be one of the treatment options which can deliver higher radiation dose to bladder tumor for elderly patients with bladder cancer who do not tolerate surgery or chemotherapy,it was overall tolerable and had good short-term efficacy.However,the optimal irradiation dose still requires further study.
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