الفهرس 
Impact of adjuvant Radiotherapy in patients with locally advanced bladder cancer on disease control and survival
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Abstract
Bladder cancer is the 6th most common male cancer worldwide and the 2nd most common in Egypt (12.7%) after liver cancer (18.7%). The optimal modality of treatment for locally advanced bladder cancer is radical cystectomy plus pelvic lymph node dissection with or without neo-adjuvant chemotherapy. Despite aggressive multimodal treatment, muscle-invasive bladder cancer outcomes remain dismal with less than 10% survival at 5 years. Perioperative chemo-therapy does not decrease pelvic recurrence rates and the median survival after loco-regional failure is only approximately 9 months. Attempts of postoperative radiotherapy evidenced to show a reduction in local recurrence and a significant improvement in DFS.
Objectives:
Our aim is to investigate if addition of adjuvant radiotherapy to chemotherapy (adjuvant or neo-adjuvant) will improve LRFS rate or survival outcomes compared with chemotherapy alone.
Methods:
In our retrospective study, we reviewed the clinical records of locally advanced bladder cancer patients who presented to our department from January 2016 to December 2020. We analyzed their different clinical and pathological criteria; and their treatment details - after radical cystectomy - with either chemotherapy, pelvic radiotherapy or both. Finally, we calculated their LRFS, DFS and OS rates together with the toxicity profiles of different treatment modalities.
Results& Conclusion:
Our study reported a LRFS, DFS and OS benefit of adjuvant radiotherapy versus chemotherapy alone or trimodality approach for high risk patients. These results highlight the inferiority of adjuvant chemotherapy in MIBC patients compared to neoadjuvant approach and adjuvant radiotherapy and this should be further studied in large prospective studies.