Efficacy of Palliative Bladder Radiotherapy for Hematuria in Advanced Bladder Cancer Using Contemporary Radiotherapy Techniques.

The aim of this study was to review the outcomes of palliative radiotherapy (RT) for hematuria treated with modern RT techniques.This was a retrospective cohort study. The primary endpoint was symptom response rate. Secondary endpoints included symptom recurrence rate, overall survival and treatment-related toxicity.Median age was 82 years (range=36-98 years). Median biologically effective dose (BED) was 36 Gy. Sixty-seven percent of patients (39/58) responded to RT. The median survival duration was 5.6 months (range=0.02-47.6 months). One third (13/39) of responders had recurrence of hematuria. Competing Risk regression with death as the competing risk showed that patients treated with low BED regimen (<36 Gy) had 5.76 times the hazard of recurrence compared to high BED regimen (>36 Gy) (p=0.01). One patient (2%) developed grade 3 nausea and vomiting which required admission for intravenous hydration.BED regimens should be recommended as they are associated with a significantly lower rate of recurrent hematuria.