Predicting survival after irradiation of metastases from transitional carcinoma of the bladder

Aim: For patients with metastatic bladder cancer, radiotherapy is a good option to control symptoms and improve outcomes. Potential prognostic factors for survival including the radiation dose were investigated. Patients and Methods: Ten factors were evaluated in 63 patients for association with survival after irradiation namely age, gender, performance status, initial T-category, initial N-category, metastases at initial diagnosis, number of metastases, metastatic sites, radiation dose and time from diagnosis of metastases to irradiation. Results: On univariate analysis, survival was negatively associated with Karnofsky performance score (KPS) ≤70 (p=0.033), initial N-category ≥1 (p=0.026) and radiation doses given as equivalent dose in 2-Gy fractions (EQD2) <20 Gy. Doses >30 Gy were slightly superior to 20- 30 Gy. On multivariate analysis, EQD2 (p=0.015) maintained its significance; a trend was found for N-category (p=0.063) and KPS (p=0.073). Conclusion: Predictors for survival after irradiation of metastases from bladder cancer were identified. Radiation doses ≥20 Gy should be used.