Adjuvant Radiation for High Risk Bladder Cancer
Bladder Cancer - Squamous Cell Carcinoma of the Bladder - Stage III Bladder Cancer - Stage IV Bladder Cancer - Transitional Cell Carcinoma of the Bladder
Conditions: official terms
Carcinoma - Carcinoma, Squamous Cell - Carcinoma, Transitional Cell - Urinary Bladder Neoplasms
Study Type
Study Phase
Phase 2
Study Design
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Name: 3D conformal radiation therapy Type: Radiation
Name: quality-of-life assessment Type: Procedure
Name: therapeutic conventional surgery Type: Procedure
Overall Status
This phase II trial studies how well modern, conformal radiation therapy after surgery works in treating patients with high-risk bladder cancer. Specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue.
Detailed Description

I. Determine the feasibility of adjuvant radiation in the management of high-risk disease.


I. Prospectively evaluate patterns of failure in high-risk bladder cancer patients after cystectomy and aggressive adjuvant therapy.

II. Define surgical and histopathologic parameters predictive of local and distant outcomes (e.g. grade, lymphovascular space invasion [LVSI], extent of resection/lymph node dissection [LND]).

III. Assess quality of life (QoL) outcomes after this treatment using a standardized questionnaires (Functional Assessment of Cancer Therapy-General [FACT-G], FACT-Bladder Cancer [BL], Expanded Prostate Cancer Index Composite [EPIC] Bowel and Urinary).


Within 12 weeks of surgical resection, patients undergo 3D conformal radiation therapy once daily 5 days per week for 28 fractions. Treatment continues in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up at 4 weeks, every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.
Criteria for eligibility
Healthy Volunteers: No
Maximum Age: N/A
Minimum Age: 18 Years
Gender: Both
Criteria: Inclusion Criteria:

- Pathologic diagnosis of urothelial or squamous cell carcinoma of the bladder

- Patients must have undergone cystectomy (total cystectomy, radical cystectomy +/- pelvic lymph node dissection) with no evidence of macroscopic residual disease

- Eastern Cooperative Oncology Group (ECOG)/Zubrod performance status of 0-2

- Patients treated with simple cystectomy with macroscopically negative margins are eligible for this study

- Clinical T-stage (prior to systemic therapy, if applicable) ≥ T3a and/or positive lymph nodes by transurethral resection of bladder tumor (TURBT)/magnetic resonance imaging (MRI)/computed tomography (CT)/positron emission tomography (PET)-CT or pathologic T-stage ≥ T3a and/or positive lymph nodes

Exclusion Criteria:

- Patients with metastatic disease outside of the pelvis

- Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 3 years

- Prior radiation therapy to the pelvis

- Patients with active inflammatory bowel disease

- Severe acute co-morbidity, defined as follows:

- Unstable angina and/or congestive heart failure requiring hospitalization in the last 3 months

- Transmural myocardial infarction within the last 6 months

- Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration

- Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration

- Acquired immune deficiency syndrome (AIDS) based upon current Centers for Disease Control and Prevention (CDC) definition; note, however, that human immunodeficiency virus (HIV) testing is not required for entry into this protocol; the need to exclude patients with AIDS from this protocol is necessary because the treatment involved in this protocol may be significantly immunosuppressive; protocol-specific requirements may also exclude immunocompromised patients
Emory University Hospital
Atlanta, Georgia, United States
Status: Recruiting
Contact: Joseph W. Shelton - 404-616-6343 -
Start Date
July 2013
Emory University
Emory University
Record processing date processed this data on July 28, 2015 page