Division of Radiotherapy, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy.
Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy.
Med Oncol. 2021 Jan 23;38(2):14. doi: 10.1007/s12032-021-01455-4.
Radiotherapy (RT) is rarely used in the palliative management of muscle-invasive bladder cancer (MIBC). This survey aims to explore current care patterns within the Italian Radiation Oncologist community on this topic. In 2020, the uro-oncological study group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) conducted a survey evaluating the RT role in advanced MIBC. An electronic questionnaire was administered online to the society members asking for: general considerations, patients' selection, and aim of the treatment, RT schedule and practical consideration, past and future perspective. Sixty-one questionnaires were returned (33% response rate). Most responders (62.30%) declared to work in a Center with a multidisciplinary uro-oncological team, and 8.20% to evaluate more than 20 patients with MIBC/year for palliative RT. Elderly patients were the most frequently evaluated (46.7%) and life expectancy was the most common selection criteria (44.60%). Thirty Gy in 10 fractions (58.9%), whole bladder as GTV (62.5%), PTV isotropic margins of 1.5-2 cm (44.6%) and IMRT/VMAT technique (58.14%) were the most common treatment choices. Patients amenable for bladder palliative RT were most commonly referred by the urologist (43.86%) or the multidisciplinary team (38%). The reported main reasons for the low involvement of radiation oncologist in the management of MIBC patients were low attention to the palliative setting in bladder cancer (37.5%); radiation oncologist not involved in the management of these patients (32.1%); cases not discussed in the multidisciplinary board (26.8%). This survey illustrated the current use of palliative RT for patients with advanced MIBC in Italy and suggested the need for a greater involvement of radiation oncologists in their management.
放射治疗（RT）在肌层浸润性膀胱癌（MIBC）的姑息治疗中很少使用。本调查旨在探讨意大利放射肿瘤学家社区在这一主题上的当前护理模式。2020 年，意大利放射肿瘤学会（AIRO）的泌尿肿瘤学研究小组进行了一项调查，评估 RT 在晚期 MIBC 中的作用。向学会成员在线发放电子问卷，询问 RT 在晚期 MIBC 中的作用：一般考虑因素、患者选择和治疗目的、RT 方案和实际考虑、过去和未来的视角。共收回 61 份问卷（33%的回复率）。大多数回答者（62.30%）表示在一个多学科泌尿肿瘤学团队的中心工作，8.20%的人每年评估 20 多名接受姑息性 RT 的 MIBC 患者。最常评估的是老年患者（46.7%），最常见的选择标准是预期寿命（44.60%）。30 Gy 分 10 次（58.9%），全膀胱作为 GTV（62.5%），PTV 各向同性边缘 1.5-2 cm（44.6%）和调强放疗/容积旋转调强技术（58.14%）是最常见的治疗选择。最常接受姑息性膀胱 RT 的患者通常由泌尿科医生（43.86%）或多学科团队（38%）转诊。报告的放射肿瘤学家在 MIBC 患者管理中参与度低的主要原因是膀胱癌姑息治疗中对姑息治疗的关注度低（37.5%）；放射肿瘤学家不参与这些患者的管理（32.1%）；多学科委员会未讨论这些病例（26.8%）。这项调查说明了意大利目前在晚期 MIBC 患者中使用姑息性 RT 的情况，并表明需要放射肿瘤学家更多地参与他们的管理。
