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dc.contributor.authorTan, MPen_US
dc.contributor.authorHarris, Ven_US
dc.contributor.authorWarren-Oseni, Ken_US
dc.contributor.authorMcDonald, Fen_US
dc.contributor.authorMcNair, Hen_US
dc.contributor.authorTaylor, Hen_US
dc.contributor.authorHansen, Ven_US
dc.contributor.authorSharabiani, Men_US
dc.contributor.authorThomas, Ken_US
dc.contributor.authorJones, Ken_US
dc.contributor.authorDearnaley, Den_US
dc.contributor.authorHafeez, Sen_US
dc.contributor.authorHuddart, RAen_US
dc.identifier.citationClinical oncology (Royal College of Radiologists (Great Britain)), 2020, 32 (2), pp. 93 - 100en_US
dc.description.abstract<h4>Aims</h4>Node-positive bladder cancer (NPBC) carries a poor prognosis and has traditionally been treated palliatively. However, surgical series suggest that a subset of NPBC patients can achieve long-term control after cystectomy and lymph node dissection. There is little published data regarding the use of radiotherapy to treat NPBC patients. This is in part due to concerns regarding the toxicity of whole-pelvis radiotherapy using conventional techniques. We hypothesised that, using intensity-modulated radiotherapy (IMRT), the pelvic nodes and bladder could be treated within a radical treatment volume with acceptable toxicity profiles.<h4>Materials and methods</h4>The Intensity-modulated Pelvic Node and Bladder Radiotherapy (IMPART) trial was a phase II single-centre prospective study designed to assess the feasibility of delivering IMRT to treat the bladder and pelvic nodes in patients with node-positive or high-risk node-negative bladder cancer (NNBC). The primary end point was meeting predetermined dose constraints. Secondary end points included acute and late toxicity, pelvic relapse-free survival and overall survival.<h4>Results</h4>In total, 38 patients were recruited and treated between June 2009 and November 2012; 22/38 (58%) had NPBC; 31/38 (81.6%) received neoadjuvant chemotherapy; 18/38 (47%) received concurrent chemotherapy; 37/38 (97%) patients had radiotherapy planned as per protocol. Grade 3 gastrointestinal and genitourinary acute toxicity rates were 5.4 and 20.6%, respectively. At 1 year, the grade 3 late toxicity rate was 5%; 1-, 2- and 5-year pelvic relapse-free survival rates were 55, 37 and 26%, respectively. The median overall survival was 1.9 years (95% confidence interval 1.1-3.8) with 1-, 2- and 5-year overall survival rates of 68, 50 and 34%, respectively.<h4>Conclusion</h4>Delivering IMRT to the bladder and pelvic nodes in NPBC and high-risk NNBC is feasible, with low toxicity and low pelvic nodal recurrence rates. Long-term control seems to be achievable in a subset of patients. However, relapse patterns suggest that strategies targeting both local recurrence and the development of distant metastases are required to improve patient outcomes.en_US
dc.format.extent93 - 100en_US
dc.subjectLymph Nodesen_US
dc.subjectProspective Studiesen_US
dc.subjectAged, 80 and overen_US
dc.subjectMiddle Ageden_US
dc.subjectRadiotherapy, Intensity-Modulateden_US
dc.titleThe Intensity-Modulated Pelvic Node and Bladder Radiotherapy (IMPART) Trial: A Phase II Single-Centre Prospective Study.en_US
dc.typeJournal Article
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfClinical oncology (Royal College of Radiologists (Great Britain))en_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Clinical Academic Radiotherapy (Huddart)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.embargo.termsNot knownen_US
icr.researchteamClinical Academic Radiotherapy (Dearnaley)en_US
icr.researchteamClinical Academic Radiotherapy (Huddart)en_US
dc.contributor.icrauthorDearnaley, Daviden_US
dc.contributor.icrauthorHuddart, Roberten_US
dc.contributor.icrauthorHafeez, Shaistaen_US
dc.contributor.icrauthorMcNair, Helenen_US

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