External beam irradiation for T1, T2–3 and T4 transitional cell carcinoma of the urinary bladder

Summary Fifty-seven patients with T 1 transitional cell carcinoma of the bladder, 57 patients with T 2–3 and 10 patients with T 4 were treated by radical irradiation ± salvage cystectomy. Thirty-five patients with Ti were treated by transurethral resection (TUR) plus local chemotherapy ± salvage cystectomy. Eleven patients with T 2–3 were treated with 5 × 4 Gy in one week followed by cystectomy while four patients with T 2–3 were treated with 40 Gy in 4 weeks also followed by cystectomy. Five patients with T 4 were treated with 40 Gy in 4 weeks plus cystectomy. Seven year survival rates are: 69% for Ti treated by radical irradiation, 43% for Ti treated by TUR ( p 2–3 treated either by radical irradiation or 5 × 4 Gy plus cystectomy, and 18% for T 4 treated by radical irradiation. All the survival rates indicated are free of disease and include the cases in which salvage cystectomy was successfully performed. Sixty per cent of the cured patients conserved very good functional bladders. We believe that external beam irradiation plus salvage cystectomy is indicated in the treatment of T 1 and T 2–3 tumours of the bladder.