الفهرس 
Acknowledgement
Role of Radiotherapy in Treatment of Bladder CancerOnly 14 pages are availabe for public view
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Abstract
Transitional cell carcinoma (TCC), also called urothelial cell carcinoma (UCC) of the bladder, is the most common primary neoplasm of the urinary bladder, and bladder TCC is the most common tumor of the entire urinary system.
In the current retrospective study we were aimed to estimate the response to modified hypofractionated radiotherapy concurrent with Gemcitabine in patients with invasive bladder cancer, in addition to estimate local control, relapse free survival, overall survival, bladder preservation rate, and to evaluate the toxicity of this protocol among patients with invasive bladder cancer who attending to South Egypt Cancer Institute, Assiut in the period from the 1st of April 2012 up to the end of December 2017.
This study included 82 patients with non-metastatic invasive bladder cancer (TNM0). The mean age of the studied participants was ± 8.81 years (range; 34 - 85 years old), the majority of the studied cases (92.7%) were aged ≥ 50 years old, and 98.8% of the studied cases were males.
Associated comorbidities were documented in one third of the studied cases, hypertension was the most common disorder, followed by cardiac disorders and diabetes mellitus. Smoking and bilharzial infestation were the most prevalent risk factors among the studied cases.
All studied participants received hpofractionation protocol in the form of 5250cGY/20 fractions by 262,5cGY fractions over 4 weeks with weekly Gemcitabine 100 mg/m2. The early toxicity profile among the studied cases revealed that 63.4% developed cystitis, 31 cases (37.8%) suffered from increased frequency of urination, 51 cases (62.2%) suffered from urgency, and two cases (2.4%) developed proctitis. 21 cases (25.6%) suffered from hematological toxicity in the form of thrombocytopenia in 12.2%, anemia in 6.1%, hepatic toxicity in 3.7%, neutropenia in 2.4%, and leukopenia in only one case (1.2%), and 15 cases (18.3%) suffered from diarrhea.
Significant reduction in the percentage of patients suffered from increased frequency of urination, urgency, and proctitis.
The overall response rate among our studied cases was 87.8%, while ten patients developed recurrence (five with loco-regional recurrence and five with distant metastasis).
The median follow-up duration of the studied 82 bladder cancer patients was 56 months (range, 5 to 94 months). During follow-up, 9/82 patients (11.0%) died. According to Kaplan-Meier analysis, at 94 month the OS rate was 84.3%. A total of 10/82 patients (12.2%) developed disease recurrence. The median time to local disease recurrence was 55 months (range, 4 to 93 months). According to Kaplan-Meier analysis, the DFS rate at 93 months was 82.8%.
According to the COX regression analysis, none of the studied clinic-pathological details of the studied patients could be considered as a significant predictor for death.