Evaluating the Current Place of Radiotherapy as Treatment Option for Patients With Muscle Invasive Bladder Cancer in Belgium |
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Authors: | Valérie Fonteyne Elke Rammant Piet Ost Yolande Lievens Bart De Troyer Sylvie Rottey Gert De Meerleer Daan De Maeseneer Dirk De Ridder Karel Decaestecker |
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Affiliation: | 1. Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium;2. Department of Radiation Oncology, University Hospitals Leuven, Belgium;3. Department of Urology, AZ Nikolaas, Sint Niklaas, Belgium;4. Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium;5. Department Development and Regeneration, Organ Systems, Urology, University Hospitals Leuven, Leuven, Belgium;6. Department of Urology, Ghent University Hospital, Ghent, Belgium |
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Abstract: |
IntroductionThere is a gap between optimal and actual use of radiotherapy (RT) in muscle-invasive bladder cancer (MIBC). We investigated the opinions of radiation-oncologists, urologists, and medical oncologists on use of RT in different cases. Barriers and facilitators for applying guidelines were examined.Material and MethodsA web-based survey was developed at Ghent University Hospital and conducted from November 18, 2016 to July 17, 2017. The place of primary, adjuvant, and palliative RT was evaluated. Additional questions assessed the use of guidelines, barriers, and facilitators.ResultsIn total, 126 physicians (57 radiation oncologists, 41 urologists, and 28 medical oncologists) completed the survey. Significant differences in use of RT in the primary and adjuvant setting were observed between radiation oncologists and urologists. Younger age and presence of hydronephrosis are perceived as contraindications for RT in the primary setting. In the adjuvant setting, RT was mainly considered in case of positive surgical margins. All radiation oncologists and 96% of medical oncologists considered palliative RT for patients with painful bone metastases, whereas 21% of urologists did not (P < .001). Clinical decisions are mainly based on EAU guidelines. The most important reason for nonadherence to guidelines is external barriers (18%). One strategy to improve awareness of guidelines is a summary of guidelines on the website of national organizations (54%).ConclusionThere is controversy regarding the place of RT in MIBC, with a clear variation between professionals. Barriers and facilitators to use RT should be addressed, seeing the gap in RT utilization and predicted increase in patients requiring RT for MIBC. |
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Keywords: | Awareness Radiation Survey Underusage Urothelial carcinoma |
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