According to the recent clinical trial, more targeted radiotherapy can treat bladder cancer that has spread to the lymph nodes of the pelvis more effectively. This type of cancer is known as node-positive bladder cancer and has a poor prognosis and hasn’t been normally treated with radiotherapy. Patients suffering from node-positive bladder cancer are conventionally offered palliative treatment for managing their pain and other symptoms.
The complete study is published in the journal “Clinical Oncology”, Feb 2020 edition.
The scientists at the Institute of Cancer Research in collaboration with the researchers at the Royal Marsden NHS Foundation Trust conducted phase II clinical trials by using radiotherapy in cancer patients which spread to lymph nodes of pelvis.
Those patients whose cancer was not spread to the lymph nodes but were had cancer which was at a high risk of spread to lymph nodes were also included in the clinical study.
The research ought to access the intensity-modulated radiotherapy use for the treatment of bladder cancer which is spread to pelvic lymph nodes and to observe the toxic effects of the treatment.
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Intensity-Modulated radiotherapy is a form of radiotherapy in which a radiation beam is shaped to fit around the tumor closely while the machine moving around the body of the patients.
Some cancer patients who have undergone chemotherapy and surgery for removing the bladder and the pelvic lymph nodes to control the disease but the radiotherapy is not specifically offered as part of their treatment plan.
Concerns about using radiotherapy for treating blood cancers in cancer center on the risks of toxicity caused by the radiotherapy treatment of pelvic region that cause symptoms like diarrhea, rectal bleeding due to disruption of the functions of the healthy tissues which surrounds cancer.
One of the professors of the Urological Cancer at the ICR Professor Robert Huddart who is the lead author of the study said that they hypothesized that use of intensity-modulated radiotherapy will maximize the radiation dose that is delivered to the tumors while minimizing the radiation dose that is delivered to the healthy cells, thus reduce the risk of adverse side effects in patients.
Some of the prostate cancer patients who participated in the trial had already undergone chemotherapy to shrink the tumor before starting he radiotherapy which is known as neoadjuvant chemotherapy. This has allowed researchers to access the results that whether chemotherapy in conjunction with radiotherapy treatment or chemotherapy alone gives the best results for such patients.
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The radiotherapy treatment was given to patients daily by using IMRT which was supported by the computed cone-beam tomography imaging, one of the types of CT scan which helps clinicians to produce a 3D virtual image of the targeted area.
Patients were followed up routinely as scheduled every six months for3 years and then yearly for up to 5 years. Almost 70.3% to 82.4% of patients suffered adverse side effects which included diarrhea and mild to severe urinary tract infections. After one year of therapy, the side effects reduced significantly. Only 5% of patients were facing side effects and a checkup after the four years of the treatment showed that none of them was facing any kind of negative side effects.
Intensity-modulated radiotherapy is a promising new choice of treatment for patients suffering from prostate cancer. Further research is needed to be done for combining both radiotherapy and chemotherapy for achieving increased survival rates and fewer relapse chances.