Promising results with image guided intensity modulated radiotherapy for muscle invasive XXXX .

@entity1 @entity137 @entity5 @entity150 @entity15929
AIM: To describe the feasibility of image guided intensity modulated radiotherapy (IG-IMRT) using daily soft tissue matching in the treatment of @entity150 . METHODS: Twenty-eight @entity1 with muscle-invasive @entity150 were recruited to a protocol of definitive radiation using IMRT with accelerated hypofractionation with @entity15929 ( @entity15929 ). Isotropic margins of .5 and 1  cm were used to generate the high risk and intermediate risk planning target volumes respectively. Cone beam CT (CBCT) was acquired daily and a soft tissue match was performed. Cystoscopy was scheduled 6  weeks post treatment. RESULTS: The median age was 83  years (range 58-92). Twenty @entity1 had @entity5 , and eight were stage IV. Gross disease received 66  Gy in 30 fractions in 11 @entity1 (ten with concurrent chemotherapy) or 55  Gy in 20 fractions for those of poorer performance status or with palliative intent. All @entity1 completed radiation treatment as planned. Three @entity1 ceased chemotherapy early due to @entity137 . Six @entity1 (21  %) had acute Grade   >=    2 genitourinary (GU) @entity137 and six (21  %) had acute Grade   >=    2 gastrointestinal (GI) @entity137 . Five @entity1 (18  %) developed Grade >= 2 late GU @entity137 and no >= 2 late GI @entity137 was observed. Nineteen @entity1 underwent cystoscopy following radiation, with complete response (CR) in 16 cases (86  %), including all @entity1 treated with chemoradiotherapy. Eight @entity1 relapsed, four of which were local relapses. Of the @entity1 with local recurrence, one underwent salvage cystectomy. For @entity1 treated with definitive intent, freedom from locoregional recurrence (FFLR) and overall survival (OS) was 90  %/100  % for chemoradiotherapy versus 86  %/69  % for radiotherapy alone. CONCLUSION: IG- IMRT using daily soft tissue matching is a feasible in the treatment of @entity150 , enabling the delivery of accelerated synchronous integrated boost with good early local control outcomes and low @entity137 .
