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Prognostic impact of local radiotherapy on metastatic urothelial carcinoma patients receiving systemic chemotherapy

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Title: Prognostic impact of local radiotherapy on metastatic urothelial carcinoma patients receiving systemic chemotherapy
Authors: Abe, Takashige Browse this author →KAKEN DB
Minami, Keita Browse this author
Harabayashi, Toru Browse this author →KAKEN DB
Sazawa, Ataru Browse this author →KAKEN DB
Chiba, Hiroki Browse this author
Kikuchi, Hiroshi Browse this author
Miyata, Haruka Browse this author
Frumido, Jun Browse this author
Matsumoto, Ryuji Browse this author →KAKEN DB
Osawa, Takahiro Browse this author →KAKEN DB
Junji, Ishizaki Browse this author
Tango, Mochizuki Browse this author
Satoshi, Chiba Browse this author
Tomoshige, Akino Browse this author
Masashi, Murakumo Browse this author →KAKEN DB
Naoto, Miyajima Browse this author →KAKEN DB
Kunihiko, Tsuchiya Browse this author →KAKEN DB
Satoru, Maruyama Browse this author →KAKEN DB
Murai, Sachiyo Browse this author
Shinohara, Nobuo Browse this author →KAKEN DB
Keywords: radiotherapy
surgery
metastatic urothelial carcinoma
chemotherapy
Issue Date: Feb-2020
Publisher: Oxford University Press
Journal Title: Japanese journal of clinical oncology
Volume: 50
Issue: 2
Start Page: 206
End Page: 213
Publisher DOI: 10.1093/jjco/hyz152
Abstract: Objective To clarify the prognostic impact of local radiotherapy on metastatic urothelial carcinoma patients treated by systemic chemotherapy. Methods Of the 228 metastatic urothelial carcinoma patients treated with systemic chemotherapy, 97 received radiotherapy mainly to metastatic sites. In patients for whom the purpose of radiotherapy was not specified, more than 50 Gy irradiation was considered to be for disease consolidation for survival analysis, while less than 50 Gy was categorized as palliation. According to the Kaplan-Meier method, we analysed overall survival from the initiation of treatment for metastatic urothelial carcinoma until death or the last follow-up, using the log-rank test to assess the significance of differences. The Cox model was applied for prognostic factor analysis. Results Overall, there was no significant difference in survival between patients with and those without radiotherapy (P = 0.1532). When analysing the patients undergoing consolidative radiotherapy separately, these 25 patients showed significantly longer survival than the 72 patients with palliative radiotherapy (P = 0.0047), with a 3-year overall survival of 43.3%. Of the present cohort, 22 underwent metastasectomy for disease consolidation, and there was no overlapping case between the metastasectomy cohort and cohort receiving consolidative radiotherapy. After controlling for four independent prognostic factors (sex, performance status, haemoglobin level and number of organs with metastasis) in our previous study, radiotherapy for disease consolidation showed a marginal value (hazard ratio = 0.666, P = 0.0966), while metastasectomy remained significant (hazard ratio = 0.358, P = 0.0006). Conclusions In the selected patients, long-term disease control could be achieved after consolidative radiotherapy for metastatic urothelial carcinoma disease. Our observations suggest that local ablative therapy (surgery or radiotherapy) could facilitate long-term disease control. However, the treatment decision should be individualized because of the lack of randomized control trials.
Rights: https://creativecommons.org/licenses/by-nc/4.0/
Type: article
URI: http://hdl.handle.net/2115/77029
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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