ASTRO guideline endorses trimodal therapy and 55 Gy in 20 fractions for bladder cancer
ASTRO recommends trimodal therapy as an alternative to cystectomy in selected muscle-invasive bladder cancer and supports 55 Gy in 20 fractions.
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bladder
Bladder-only radiotherapy substantially irradiated adjacent pelvic nodes regardless of IMRT technique
Obturator nodes received about 75% of the prescribed bladder dose incidentally, with similar regional exposure from VMAT and fixed-field IMRT.
SBRT controlled bone lesions but rarely delayed systemic therapy in bladder cancer
Two-year local control reached 88%, but median progression-free survival was 5.8 months and systemic treatment changed after 4.4 months.
Bladder dose escalation reduced invasive recurrence without increasing toxicity
Two-year invasive recurrence fell from 27.5% to 5.5% with dose escalation, without higher grade 2 or greater toxicity.
USP15-FIS1 signaling sensitized bladder cancer to radiotherapy through mitochondrial dysfunction
USP15 stabilized FIS1, suppressed oxidative phosphorylation, and increased radiosensitivity; metformin restored radiation response in USP15-low bladder cancer models.