Recommendations for planning and delivery of radical radiotherapy for localized urothelial carcinoma of the bladder - Centre de Recherche en Cancérologie et Immunologie Nantes Angers Access content directly
Journal Articles Radiotherapy & Oncology Year : 2021

Recommendations for planning and delivery of radical radiotherapy for localized urothelial carcinoma of the bladder

Stéphane Supiot
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  • PersonId : 1041626
Christophe Hennequin
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  • PersonId : 1022091
Nicolas Magné
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  • PersonId : 936917
Igor Latorzeff
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  • PersonId : 949033
Gilles Créhange
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  • PersonId : 1110793
Morgan Rouprêt
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  • PersonId : 1003501
Arnaud Mejean
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  • PersonId : 854054
Stéphane Culine
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  • PersonId : 1110257
Paul Sargos
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  • PersonId : 1042270

Abstract

Purpose: Curative radio-chemotherapy is recognized as a standard treatment option for muscle-invasive bladder cancer (MIBC). Nevertheless, the technical aspects for MIBC radiotherapy are heterogeneous with a lack of practical recommendations.Methods and materials: In 2018, a workshop identified the need for two cooperative groups to develop consistent, evidence-based guidelines for irradiation technique in the delivery of curative radiotherapy. Two radiation oncologists performed a review of the literature addressing several topics relative to radical bladder radiotherapy: planning computed tomography acquisition, target volume delineation, radiation schedules (total dose and fractionation) and dose delivery (including radiotherapy techniques, image-guided radiotherapy (IGRT) and adaptive treatment modalities). Searches for original and review articles in the PubMed and Google Scholar databases were conducted from January 1990 until March 2020. During a meeting conducted in October 2020, results on 32 topics were presented and discussed with a working group involving 15 radiation oncologists, 3 urologists and one medical oncologist. We applied the American Urological Association guideline development's method to define a consensus strategy.Results: A consensus was obtained for all 34 except 4 items. The group did not obtain an agreement on CT enhancement added value for planning, PTV margins definition for empty bladder and full bladder protocols, and for pelvic lymph-nodes irradiation. High quality evidence was shown in 6 items; 8 items were considered as low quality of evidence.Conclusion: The current recommendations propose a homogenized modality of treatment both for routine clinical practice and for future clinical trials, following the best evidence to date, analyzed with a robust methodology. The XXX group formulates practical guidelines for the implementation of innovative techniques such as adaptive radiotherapy.
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Dates and versions

hal-03612787 , version 1 (02-08-2023)

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Attribution - NonCommercial

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Jonathan Khalifa, Stéphane Supiot, Géraldine Pignot, Christophe Hennequin, Pierre Blanchard, et al.. Recommendations for planning and delivery of radical radiotherapy for localized urothelial carcinoma of the bladder. Radiotherapy & Oncology, 2021, 161, pp.95-114. ⟨10.1016/j.radonc.2021.06.011⟩. ⟨hal-03612787⟩
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