Daniel A. Hamstra, MD, PhD, FASTRO, FASCO, presented “Updates in Radiotherapy for Bladder Cancer” during the 28th Annual Innovations in Urologic Practice conference on September 22, 2024, in Denver, Colorado.
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How to cite: Hamstra, Daniel A. “Updates in Radiotherapy for Bladder Cancer.” September 22, 2024. Accessed Dec 2024. https://grandroundsinurology.com/updates-in-radiotherapy-for-bladder-cancer/
Updates in Radiotherapy for Bladder Cancer – Summary
Daniel A. Hamstra, MD, PhD, FASTRO, FASCO, explores advances in bladder cancer therapy, focusing on trimodality bladder preservation. In this 21-minute presentation, he compares the North American approach, which requires strict criteria for bladder preservation, including thorough TURBT and an absence of extensive CIS, to a more inclusive UK approach, which tolerates certain conditions such as CIS and hydronephrosis and utilizes non-platinum-based chemotherapy.
Hamstra shares a significant UK phase III trial that illustrates the effectiveness of adding chemotherapy to radiation, enhancing local control and survival, and reducing the need for cystectomy. A multi-institutional study comparing this approach with radical cystectomy indicates comparable metastasis-free and overall survival rates, suggesting trimodality therapy as a viable alternative to surgery.
Hamstra notes that neoadjuvant chemotherapy is emerging as beneficial in bladder preservation, with data supporting its utility across different cancers when combined with radiation. For node-positive bladder cancer, combined chemoradiotherapy (chemoRT) appears as effective as surgery in appropriately selected patients.
Newer immunotherapies and non-platinum regimens continue to expand options, while evidence supports chemoRT as an alternative to radical surgery, especially for patients prioritizing quality of life and organ preservation.
About The 28th Annual Innovations in Urologic Practice:
Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, the conference also includes pelvic reconstruction and trauma; men’s health topics like male infertility, andrology, and sexual dysfunction; OAB and voiding dysfunctions; and ways to diagnose and treat infections in the urology patient.
For further educational activities from this conference, visit our collection page.