The role of radiotherapy in the treatment of muscle invasive bladder cancer.

The treatment of muscle invasive bladder cancer still remains controversial. It is becoming more clear, however, that attempts to retain the functional capacity of the urinary bladder by the use of non-surgical methods may be of benefit in the long-term. Studies using radiotherapy in combination with chemotherapeutic agents or intravesicle sensitizers, or the use of radiotherapy alone, but optimized (i.e., brachytherapy and altered fractionation) may be able to achieve improved local control whilst retaining a functional bladder. Attempts to couple this with improved survival due to the sterilization of occult metastases is still subject to much debate.