Sadiq Sadia, Khawaja Arham Amir, Mehmood Qadri Haseeb
Radiation Oncology, Institute of Nuclear Medicine and Oncology (INMOL) Atomic Energy Cancer Hospital, Lahore, PAK.
General Surgery and Surgical Oncology, Shaikh Zayed Medical Complex, Lahore, PAK.
Cureus. 2025 Aug 6;17(8):e89460. doi: 10.7759/cureus.89460. eCollection 2025 Aug.
Urinary bladder cancer contributes significantly to the global cancer burden and is more prevalent in the developed world. We present the case of a 54-year-old male smoker who underwent transurethral resection of bladder tumor and consequent trimodality therapy (induction chemotherapy followed by concomitant chemo-radiotherapy). His disease was staged at cT3N0M0. Cone beam computed tomography (CBCT) and plan-of-the-day adaptive radiotherapy (ART) were utilized to treat muscle-invasive bladder urothelial carcinoma (MIBC). Instead of the usual planning treatment volume (PTV) of 2 cm, the disease-free state was achieved with a small PTV of 5 mm in 18 fractions and a large PTV of 1.5 cm in two fractions only. The volume of bowel saved with this strategy was 180 cc. The patient tolerated the treatment well with no side effects and is living a healthy life till date. CBCT-guided ART with plan-of-the-day approach is a precise and effective approach for the management of MIBC within limited resources.
膀胱癌对全球癌症负担有重大影响，在发达国家更为普遍。我们报告一例54岁男性吸烟者的病例，该患者接受了经尿道膀胱肿瘤切除术及随后的三联疗法（诱导化疗后序贯同步放化疗）。其疾病分期为cT3N0M0。采用锥形束计算机断层扫描（CBCT）和当日计划自适应放疗（ART）治疗肌层浸润性膀胱尿路上皮癌（MIBC）。与通常2 cm的计划靶体积（PTV）不同，该患者仅通过18次分割的5 mm小PTV和2次分割的1.5 cm大PTV就实现了无病状态。通过该策略节省的肠体积为180 cc。患者对治疗耐受性良好，无副作用，至今生活健康。CBCT引导下的当日计划ART是在资源有限的情况下管理MIBC的一种精确且有效的方法。
