100例逐级加量全程加速超分割治疗食管癌的研究

目的：探讨逐级加量全程加速超分割和后程加速超分割治疗食管癌的疗效和毒性。方法：100例符合入组条件的食管鳞癌病例随机分为逐级加量全程加速超分割放疗组（全程组）和后程加速超分割放疗组（后程组）各50例。后程组前4周常规放疗，每天照射1次，DT40Gy，20次，后2周超分割放疗，每天照射2次，每次DT1．5Gy，间隔6～8小时，DT30Gy，总剂量DT70Gy，40次，40～45天；全程组采用全程超分割放疗，每天照射2次，间隔6～8小时，第1、2周每次照射DT1．2Gy，第3、4周每次照射DT1．4Gy，第5周每次照射DT1．6Gy，总剂量DT68Cy，50次，34～38天。结果：全部病例随访率100％。全程组和后程组的1、2、3年局部控制率分别为78．5％、72．8％、70．8％和77．7％、69．1％、55．3％（P=0．054）；1、2、3年生存率分别为94％、64％、50％和84％、60％、37％（P=0．049）。急性反应和后期损伤无明显差异（P〉0．05）。结论：逐级加量全程加速超分割提高了食管癌放疗的局控率，有可能提高长期生存率。正常组织急性反应和晚期放射损伤并没有增加。     

98例晚期上颌窦癌疗效分析

目的：分析晚期上颌窦癌治疗效果。材料与方法：１９８３－１９８９年我院收治９８例晚期上颌窦癌采用单纯放疗，术前放疗和术后放疗，单纯放疗中１０例先行开窗引流。结果：全组１，３，５年生存率分别为７０．４％，３８．８％和３０．６％。单纯放疗，开窗＋放疗，术前和术后放疗组５年生存率分别为２６．９％，５０％，５５．５％和２２．２％。失败原因主要是局部未控或复发。结论：对晚期上颌窦癌行术前放疗和开窗引流术加放疗     

98例晚期上颌窦癌疗效分析

分析晚期上颌窦癌治疗效果。材料与方法：1983～1989年我院收治98例晚期上颌窦癌采用单纯放疗、术前放疗和术后放疗。单纯放疗中10例先行开窗引流。结果：全组1、3、5年生存率分别为70．4％．38．8％和30．6％。单纯放疗、开窗＋放疗、术前和术后放疗组5年生存率分别为26．9％。50％、55．5％和22．2％。失败原因主要是局部未控或复发。结论：对晚期上颌窦癌行术前放疗和开窗引流术加放疗疗效较好。     

局部晚期上颌窦癌常规照射与全程加速超分割照射疗效

目的 比较上颌窦癌常规外照射与全程加速超分割治疗的生存率和局部控制率。方法 1996年3月－2001年10月住院治疗的47例上颌窦癌随机分成常规治疗组（CF），全程加速超分割治疗组（WCAHF），常规照射26例200cGy／次、1次／d、5次／w，DT75－80Cy/38-45次／45－56d；全程超分割21例，1．5Gy/次，2次／d，间隔6h以上，DT75－80Gy/50-54次／35－42天。结果 CF组和WCAHF组1、2、3年局控率为65．4％、34．6％、19．2％和90．5％、66．7％、52．3％。CF组和WCAHF组1、2、3年生存率分别为65．4％、44．8％、23．1％和为95．2％、76．2％、57．1％，全程加速超分割组明显优于常规组。2个组差异有显意义（P＜0．05）。结论 全程加速超分割放射治疗明显提高局部晚期上颌窦癌的局控及生存率。     

放射治疗100例上颌窦癌

1980年1月至1984年12月放射治疗100例上颌窦癌,Ⅱ期8例,Ⅲ期52例,Ⅳ期40例。单纯放疗60例,术后放疗32例,术前放疗2例,术前 术后放疗6例,放疗剂量40～70Gy/4～7周,总5年生存率36.0％,单纯放疗5年生存率20.0％,术后放疗5年生存率53.1％,其中19例手术残存或未控者行术后放疗,5年生存率36.8％,术后放疗剂量以50～60Gy/5～6周疗效较好。上颌窦癌晚期病人实行手本、放疗的综合治疗是提高生存率的重要途径。     

食管癌放射治疗时间—剂量关系探讨

本文探讨了在食管癌的常规分割放疗中，总治疗时间的改变对局控率和生存率的影响，分析了我院从1990－1994年收治的206例经病理确诊为食管鳞状细胞癌病人，其中连续治疗组116例，分段治疗组90例，两组均采用8Mv-X线及^60Co-γ线照射，靶区总剂量60－70Gy，每周5次，每次1．8－2．0Gy。分段组照射DT3000－4000CGy时有1－2周的休息。连续治疗组1、2、3年生存率分别为56％、32％、21％，1年局控率T155％，T220％；分段治疗组1、2、3年生存率分别为55％、29％、14％、1年局控率T1 39％，T2 14％，连续治疗组生存率与局控率明显高于分段治疗组，本文指出在食管癌的放射治疗中，应尽量避免间断治疗。     

鼻咽癌适形和常规放疗的比较

目的：比较鼻咽癌立体定向适形放疗和常规放疗的效果及放疗反应。方法：共130例鼻咽癌患者，立体定向放疗组81例、普通放疗组49例，定向放疗组靶区为鼻咽肿瘤、咽旁间隙和颈部淋巴区，95％剂量曲线，分次剂量为3．0—3．5Gy／次，10—14次；普放组用面颈联合野照射D，36—40Gy／18—20次／3—4周，耳前野补量至鼻咽区DT 70Cy；颈部预防总量为DT50-55Gy。结果：立体定向放疗组和普放组1年局控率分别为91．36％（74／81例）、89．80％（44／49例）；1、3年生存率立体定向放疗组为96．30％（78／81）、91．35％（74／81），普放组95．92％（47／49），89．80％（44／49），两组比较局控率和生存率无显著差异。立体定向放疗组和普放组口干发生率分别为9．88％（8／81）和93．88％（46／49）；张口困难发生率分别为4．94％（4／81）和85．7％（42／49）；两组比较，差异均有显著性（P〈0．01）。结论：鼻咽癌立体定向放疗与单纯普放局控率无显著差异，但放疗反应明显降低。     

非小细胞肺癌脑转移临床分析

目的：探讨非小细胞肺癌脑转移预后因素及有效的治疗方法。方法：对我科收治以脑转移为首发症状非手术治疗的非小细胞肺癌患者68例进行分析。治疗方法：脑部放疗采用Co-γ线或6MV-X线两侧平行野对穿全脑放疗，每次DT180—200cGy，剂量达DT40Gy，单一转移病灶缩野加量放疗至DT56Gy-64Gy。放疗的同时用甘露醇脱水及地塞米松对症治疗。放化组全脑放疗结束后行顺铂＋盖诺方案化疗2周期-4周期。部份病例化疗结束后，肺部原发病灶加用Co-γ线或6MV-X线局部小野照射治疗，每次DT2Gy，剂量DT56Gy～66Gy。结果：全部病例均随访2年以上，随访率100％。全组1年生存率39．7％，2年生存率20．6％。放化疗组患者1、2年生存率分别为48．8％、25．6％，明显高于单纯放疗组（P〈0．05）。脑单发转移灶1、2年生存率分别为59．1％、30．4％，明显高于多发转移病灶组（P〈0．05）。只伴发颅内转移患者，1、2年生存率分别为59．5％，37．8％，均明显高于伴有颅外转移患者（P〈0．01）。结论：影响非小细胞肺癌脑转移预后因素主要与治疗方法、脑转移数、有无合并颅外转移有关。积极有效的放、化疗是缓解症状，提高生存质量，延长生存时间的关键。     

诱导化疗加放射综合治疗局部晚期鼻咽癌的临床分析

目的：探讨诱导化疗对局部晚期鼻咽癌放疗疗效的影响,方法：96例Ⅲ、Ⅳ期鼻咽癌随机分为两组（化疗组及单放组）,每组48例,放疗采用^60Co机或直线加速器照射鼻咽及颈部,鼻咽剂量DT66－76Gy／6．5－7．5周,颈部剂量DT50－70Gy／5－7周。诱导化疗采用DDP＋5－FU方案。结果：化疗组一、三、五年生存率分别为为94．2％、72．9％、65．75;单放组分别为89．1％、56．8％、46．85,有显著性差异（P＜0．05）。化疗组一、三、五年局控率各为89．2％、71．4％、63．9％;单放组各为82．5％（50．1％、44．2％）,有显著性差异（P＜0．05）。化疗组远处转移率为为20．95,单放组为41．75,两组比较有显著性差异（P＜0．05）。结论：诱导化疗能提高局部晚期鼻咽癌放疗的局控率及生存率,降低远处转移。     

124例上颌窦癌预后因素分析

目的探讨上颌窦癌的临床病理特征与预后的关系。方法124例上颌窦癌中放疗40例，手术治疗18例，放疗＋手术治疗66例。生存率计算采用Kaplan-Meier法，生存率差异比较采用Logrank检验，多因素分析采用Cox模型。结果5年总生存率、癌症相关生存率和无进展生存率分别为32.5％、37．4％和27．2％。单因素分析显示，肿瘤位置、病理类型、T分期、淋巴结转移情况、临床分期和治疗方式与癌症相关生存（CSS）和无进展生存（PFS）均有相关性；而年龄仅与CSS相关，而与PFS无关。多因素分析显示，病理类型、T分期、临床分期和治疗方式是影响预后的独立因素。结论T分期和临床分期是影响上颌窦癌预后的重要因素。对113～T4期即使淋巴结阴性上颌窦鳞癌，予以颈部预防性照射也是必要的。上颌窦癌的最佳治疗模式仍有待进一步研究。     

早期乳腺癌保乳术后全乳大分割照射同步瘤床加量的临床分析

目的：观察早期乳腺癌保乳术后全乳大分割照射同步瘤床加量的短期疗效与不良反应。方法64例早期乳腺癌患者保乳术后行两野切线全乳照射,全乳腺照射40．5 Gy／15 f,单次剂量2．7 Gy／f,同步瘤床推量至48 Gy／15 f,单次剂量3．2 Gy／f,总疗程3周,观察分析患者局部复发情况、美容效果及不良反应。结果中位随访时间17月,随访率为100％,无局部复发情况发生。3例患者表现乳腺中度胀痛;Ⅰ、Ⅱ、Ⅲ级急性皮肤反应发生率分别为17．2％、4．7％、1．6％;Ⅰ级血小板下降发生率与Ⅰ～Ⅱ级中性粒细胞减少发生率分别为1．6％、4．7％;放疗完成后4、7月美容优良率分别为90．6％、87．5％。结论早期乳腺癌保乳术后全乳放疗同步瘤床加量的短期疗效与以往常规放疗方式相似,缩短放疗时间,不会增加皮肤不良反应及降低美容效果。     

Oxaliplatin with raltitrexed and preoperative radiotherapy in T3-T4 extraperitoneal rectal cancer. A dose finding study

AIMS AND BACKGROUND: The availability of new drugs offers the opportunity to improve the outcome of locally advanced rectal cancer. Raltitrexed and oxaliplatin are effective in advanced colorectal cancer with acceptable toxicity and can act as radiation enhancers as shown in phase I-II studies. The aim of the study was thus to determine the recommended dose of oxaliplatin concomitantly administered with raltitrexed and concurrent preoperative radiotherapy in patients with stage II-III extraperitoneal rectal cancer. METHODS: From September 2001 to September 2002, 18 consecutive patients with T3/T4 rectal cancer were treated at our Institution with preoperative chemoradiation followed by surgery after 6-8 weeks. Pelvic radiotherapy was delivered at a dose of 45 Gy in 25 fractions in 5 weeks followed by a 5.4 Gy boost at 1.8 Gy daily. Concomitant chemotherapy consisted of 3 mg/m2/i.v. of raltitrexed on days 1, 19, 38 of radiotherapy treatment with incremental doses of oxaliplatin according to dose finding rules (4 dose levels: 65, 85, 110, 130 mg/m2). Dose-limiting toxicity for oxaliplatin was defined as either grade 3-4 hematological or grade 3-4 gastrointestinal or neurological toxicity. We studied a minimum of 3 patients at each dose level. RESULTS: Three patients were treated at 65, 85, and 110 mg/m2/i.v., respectively, while 9 patients were recruited at the last dose level. Neither grade 3-4 gastrointestinal nor neurological toxicity were documented. Dose-limiting toxicity was documented in 2/9 subjects at the 130 mg/m2 level consisting of grade 3 transient asymptomatic leukopenia. Thirteen patients developed transient increase of one or more liver enzymes (grade 3-4) and 2 patients developed grade 3 perineal dermatitis. All patients received the programmed dose of radiotherapy. The chemotherapy regimen was not completed in 4 cases due to grade 2 protracted leukopenia. CONCLUSIONS: The maximum tolerated dose of oxaliplatin was not reached at the maximum dose level (i.v.); 130 mg/m2 can therefore be defined as the recommended dose. The combination of oxaliplatin with raltitrexed and radiotherapy can be considered feasible and well tolerated.     

Results of multimodality therapy for squamous cell carcinoma of maxillary sinus

BACKGROUND: A wide variety of modalities, including surgery, radiation therapy, and chemotherapy, alone or in combination, have been used for the treatment of squamous cell carcinoma (SCC) of the maxillary sinus to obtain better local control and maintain functions. However, there is still much controversy with regard to the optimum treatment. METHODS: From 1987 to 1999, 33 patients with SCC of maxillary sinus were treated at the Department of Otolaryngology-Head and Neck Surgery, University of Tokyo Hospital. The treatment consisted of 30-40 grays (Gy) of preoperative radiotherapy with concomitant intraarterial infusion of 5-fluorouracil and cisplatin followed by surgery and 30-40 Gy of postoperative radiotherapy, for tumors without skull base invasion. For tumors invading the skull base, preoperative systemic chemotherapy with or without radiotherapy was performed, instead of intraarterial chemotherapy, then followed by skull base surgery. The surgical procedures varied according to the extent of tumor. Results were compared with those of the 108 patients treated in our hospital from 1976 to 1982. RESULTS: Partial maxillectomy was performed in 2 T2 patients and 12 T3 patients. Total maxillectomy was performed in 1 T2 patient, 3 T2 patients, and 7 T4 patients. Skull base surgery was performed in eight T4 patients. Orbital content and hard palate were preserved in 22 patients and 18 patients, respectively. The overall 5-year survival rates were 86% in T 3 patients and 67 % in T4 patients, respectively. CONCLUSIONS: Our multimodal treatment has provided favorable local control and survival outcome with good functional results.     

Prospective trial of preoperative concomitant boost radiotherapy with continuous infusion 5-fluorouracil for locally advanced rectal cancer

RATIONALE: To evaluate the response to a concomitant boost given during standard chemoradiation for locally advanced rectal cancer. METHODS AND MATERIALS: Concomitant boost radiotherapy was administered preoperatively to 45 patients with locally advanced rectal cancer in a prospective trial. Treatment consisted of 45 Gy to the pelvis with 18 mV photons at 1.8 Gy/fraction using a 3-field belly board technique with continuous infusion 5FU chemotherapy (300mg/m(2)) 5 days per week. The boost was given during the last week of therapy with a 6-hour inter-fraction interval to the tumor plus a 2-3 cm margin. The boost dose equaled 7.5 Gy/5 fractions (1.5 Gy/fraction); a total dose of 52.5 Gy/5 weeks was given to the primary tumor. Pretreatment tumor stage, determined by endorectal ultrasound and CT scan, included 29 with T3N0 [64%], 11 T3N1, 1 T3Nx, 2 T4N0, 1 T4N3, and 1 with TxN1 disease. Mean distance from the anal verge was 5 cm (range 0-13 cm). Median age was 55 years (range 33-77 years). The population consisted of 34 males and 11 females. Median time of follow-up is 8 months (range 1-24 months). RESULTS: Sphincter preservation (SP) has been accomplished in 33 of 42 (79%) patients resected to date. Three patients did not undergo resection because of the development of metastatic disease in the interim between the completion of chemoradiation (CTX/XRT) and preoperative evaluation. The surgical procedures included proctectomy and coloanal anastomosis (n = 16), low anterior resection (n = 13), transanal resection (n = 4). Tumor down-staging was pathologically confirmed in 36 of the 42 (86%) resected patients, and 13 (31%) achieved a pathologic CR. Among the 28 tumors (67%) located <6 cm from the anal verge, SP was accomplished in 21 cases (75%). Although perioperative morbidity was higher, toxicity rates during CTX/XRT were comparable to that seen with conventional fractionation. Compared to our contemporary experience with conventional CTX/XRT (45Gy; 1.8 Gy per fraction), improvements were seen in SP (79% vs. 59%; p = 0.02), SP for tumors <6 cm from the anal verge (75% vs. 42%; p = 0.003), and down-staging (86% vs. 62%; p = 0.003). CONCLUSION: The SP rate with concomitant boost radiation has been highly favorable with rates of response which are higher than those previously reported for chemoradiation without administration of a boost. Further evaluation of this radiotherapeutic strategy appears warranted.     

A phase II study of concomitant boost radiation plus concurrent weekly cisplatin for locally advanced unresectable head and neck carcinomas.

BACKGROUND AND PURPOSE: This phase II study evaluated the efficacy and toxicity of weekly cisplatin along with concomitant boost accelerated radiation regimen in patients with locally advanced unresectable head and neck carcinoma. MATERIAL AND METHODS: A total of 94 patients (median age, 58 years) with UICC stage III (n = 19) and IV (n = 75) cancer of the oropharynx, larynx, hypopharynx and oral cavity were included. Patients received radiotherapy with a concomitant boost scheme (1.8 Gy on days 1-40 and 1.5 Gy boost on days 25-40 with a total dose of 72 Gy) and concurrent cisplatin, 40 mg/m(2) weekly, for the first 4 weeks. RESULTS: Most patients (95%) received both radiation and chemotherapy according to protocol. Toxicity was manageable with grade III mucositis and pharyngeal-oesophageal toxicity in 85 and 50% of patients, respectively. Haematological toxicity was mild. Four patients (4%) died due to complications. With a median follow of 41 months, median overall survival and time to progression were 27 and 25 months, respectively. The estimated overall survival at 4 years was 41%. CONCLUSIONS: Concomitant boost accelerated radiation plus concurrent weekly cisplatin is a feasible schedule in patients with locally advanced unresectable head and neck carcinoma, with acceptable toxicity and survival data.     

鼻咽癌常规放射治疗后颅底推量的临床价值评估

[目的]探讨颅底受累鼻咽癌常规放疗后颅底推量的临床价值。[方法]2000年1月至2001年12月经病理学确诊、影像学证实有颅底骨质破坏、常规放疗剂量为68～72Gy的初治鼻咽癌患者共497例,其中,120例于放疗结束时即予双侧颅底野推量6～12Gy（推量组）,377例无颅底推量（无推量组）。局控率、总生存率及神经系统放射性并发症发生率为主要评价指标。[结果]中位随访时间60.7个月（5.1～109.5个月）。两组5年鼻咽控制率、颅底颅内控制率、总生存率和无颅神经损伤发生率比较均无显著性差异,但推量组的5年无颞叶坏死发生率明显低于无推量组（71.4%vs91.1%,P〈0.001）。以蝶窦、海绵窦、筛窦侵犯和T3、T4期作为5个亚组进行分析,结果显示颅底推量均不能提高各亚组的颅底颅内控制率和总生存率。[结论]常规放疗后采用颅底野对颅底受累的鼻咽癌患者推量的方法未能获得局控率和总生存率的改善,但可使放射性颞叶坏死发生率明显增加。     

Concomitant boost radiotherapy for muscle invasive bladder cancer.

PURPOSE: To evaluate the feasibility and efficacy of a concomitant partial bladder boost schedule in radiotherapy for invasive bladder cancer, coupling a limited boost volume with shortening of the overall treatment time. METHODS AND MATERIALS: Between 1994 and 1999, 50 patients with a T2-T4 N0M0 transitional cell carcinoma of the bladder received radiotherapy delivered in a short overall treatment time with a concomitant boost technique. With this technique a dose of 40 Gy in 2-Gy fractions was administered to the small pelvis with a concomitant boost limited to the bladder tumor area plus margin of 15 Gy in fractions of 0.75 Gy. The total tumor dose was 55 Gy in 20 fractions in 4 weeks. Toxicity was scored according to EORTC/RTOG toxicity criteria. RESULTS: The feasibility of the treatment was good. Severe acute toxicity >/=G3 was observed in seven patients (14%). Severe late toxicity >/=G3 was observed in six patients (13%). Thirty-seven patients (74%) showed a complete and five (10 %) a partial remission after treatment. The actuarial 3-year freedom of local progression was 55%. CONCLUSION: In external radiotherapy for muscle invasive bladder cancer a concomitant boost technique coupling a partial bladder boost with shortening of the overall treatment time provides a high probability of local control with acceptable toxicity.     

局部晚期食管鳞癌后程加速超分割放疗联合化疗的临床研究

 目的 研究后程加速超分割放疗联合化疗治疗局部晚期食管鳞癌的疗效。方法 将76例局部晚期食管鳞癌患者随机分为后程加速超分割放疗联合化疗（LCAF+CT）组及常规放疗联合化疗（CF+CT）组。LCAF+CT组于放疗前先行诱导化疗2次，化疗后先行常规分割放疗至36 Gy，缩野后程加速超分割放疗至原发灶总剂量60～66 Gy。CF+CT组化疗方法与LCAF+CT组相同，放疗采用常规分割，原发灶总剂量为60～66 Gy。结果 LCAF+CT组的1，3，5年生存率分别为81.6 %，47.4 %，34.2 %，CF+CT组的1，3，5年生存率分别为73.7 %，31.6 %，18.4 %。两组间3，5年生存率比较差异有统计学意义（P＜0.05）。LCAF+CT组毒副反应较重，两组的死亡原因主要为局部复发，其次为远处转移，差异无统计学意义（P＞0.05）。结论 LCAF+CT治疗局部晚期食管鳞癌，可以提高疗效，延长生存期，虽毒副反应略增加，但患者均可耐受。     

External irradiation prior to conservative surgery for breast cancer treatment.

From 1981 to 1987, 138 patients with breast cancer unsuitable for primary tumorectomy received initial external radiotherapy (45 Gy/25f/35d) in order to reduce the tumor volume so that secondary limited surgery could be performed. There were 81 T2 and 57 T3. Fifty-seven percent of the patients had a tumor larger than 4.5 cm. After completion of the radiotherapy, 22 patients (16%) showed no more evidence of a tumor either clinically or radiologically and received a boost of 25 Gy. In 52 cases (38%) the tumor regression allowed for secondary tumorectomy followed by a boost of 20 Gy. Sixty-four patients (46%) showed either little or no tumor regression: radical surgery was performed in 14 cases (10%) and high dose boost curietherapy (37 Gy) in the 50 (36%) remaining patients who refused mastectomy. Breast conservation in good condition was thus obtained in 74 patients (54%). Sufficient tumor regression to allow secondary tumorectomy was more often observed in T2 than in T3, in poorly differentiated tumors or mucinous type, and in tumor with well defined mammographic aspects. Actuarial 5-year local control and disease-free survival rates after limited surgery were, respectively, 90% and 73%. No particular complications were observed after secondary tumorectomy. This therapeutic approach is encouraging in patients with large T2 and T3 breast tumors, but a longer follow-up is required to assess definitive conclusions.     

Trimodality Therapy in which Concurrent Chemoradiation with Concomitant Boost in Muscle Invasive TCC Urinary Bladder Cancer

Background: Bladder cancer is the most common genitourinary tract malignancy among Egyptian males (16%). bladder sparing therapy can be considered an alternative for patients refusing surgery or are not candidates for surgery. The objective of this study was to determine the safety and feasibility of external-beam irradiation with concomitant boost in muscle invasive bladder cancer and to determine the short-term (1-year) risk of recurrence of bladder cancer. Methods: Between October 2019 and November 2021, we enrolled 42 patients in Prospective, one arm trial. Eligible patients had pathologically confirmed TCC transitional cell carcinoma of the bladder cT2-4aN0M0, who refused surgery or had contraindications to surgery, and treated conservatively with radiotherapy. All patients underwent maximal TURB before beginning of chemoradiation therapy which was delivered in all patients The patients received radiotherapy dose 45 Gy/25 fractions (1.8 Gy) per fraction to the whole bladder+ 3 cm. with   concurrent cisplatin 20 mg/ m2 over 30 minutes  before radiation on days 1,2,15,16,29, and 30. Additionally, concomitant boost limited to the bladder plus1.5 cm margin was deliverd during the last ten days of the treatment with a minimum 6 h gap between fractions, to a total dose 60 Gy, with the overall treatment time equal to 5 weeks. Results: The median overall survival OS for 42 patients with transitional cell carcinoma( TCC) of bladder treated with 3D conformal radiotherapy 3DCRT and concomitant boost was 28 months, the mean OS was 29.9±1.04, and (95% confidence interval=27.9-32). The one-year OS was 100%, 2-year OS was 81%, and 3-year OS was 26.2%.The mean loco-regional relapse free survival (LRRFS) was 31.6±1.8, 95% CI=28.1-35.1, and the median was 26.5±1.4, the one-year loco-regional RFS was 92.9%, and 2-year (LRRFS) was 66.7%.Acute and late genitourinary toxicity was grade 2 in most of patients and also acute and late toxicity of gastrointestinal was equal or less than grade 1. Conclusion: In external radiotherapy for muscle invasive bladder cancer a concomitant boost technique of invasive bladder cancer with shortening of the overall treatment time provides a high probability of local control and overall survival with acceptable toxicity.