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JCDR. 2021; 12(6): 1531-1537

Treatment Related Toxicity of Hypofractionated Radiation Therapy with Capecitabinein Muscle Invasive Bladder CancerElderly Patients

Amira Hany Hanna, Seham Elhagrasy, Alaa Fayed,Amira Elwan.


Background: Bladder cancer can be clinically classified by stage as either muscle invasive or
non-muscle invasive based on involvement of the detrusor muscle.Radical cystectomy and
selective bladder preserving therapy are bothconsidered standard of care treatment options for
non-metastatic, muscle-invasive bladder cancer. Purpose: To decrease the toxicity of concurrent
chemoradiation in old age non metastatic bladder cancer patients.Patients and method: 24
Patients ineligible for radical cystectomy or high-intensity chemoRT underwent transurethral
resection of bladder tumour followed by capecitabine (median 850 mg/m2/d BID) and
hypofractionatedradiotherapy (total dose of 55 Gy was given in 25 fr) at the Clinical Oncology
and Nuclear Medicine department, Zagazig University Hospitals from August 2019 to August
2021. Results:A total of 24 patients (with a median age of 67 years) were treated. Only grade
1 (anaemia in one patient (4.2 %), leucopenia in three patients (12.5%), hyperbiliribinemia in
two patients( 8.3 %), grade 2 (diarrhea in two patients (8.3 %), skin toxicity in one (4.2 %) of
patients, hand foot syndrome in two patients (8.3 %), and acute urogenital toxicity were
present;G1 dysuria was reported by 58.3%, G1 frequency by 45.8%, G1 urgency by 37.5 %,
and G1 hematuria by 29.1%.Conclusions: For elderly patients, Hypofractionated chemo-RT
with capecitabine is a tolerable regimen with effective local control that may increase the
utilization of definitive treatment for bladder cancer.

Key words: Cancer bladder, Elderly ,Hypofractionated radiotherapy,capecitabine,Toxicity

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