For gross hematuria from a primary bladder tumor, what palliative radiation regimen would you recommend?
How do you decide between 30 Gy/10 fx, 20 Gy/5 fx, 21 Gy/3 fx?
Answer from: Radiation Oncologist at Community Practice
I found that 36 Gy/6 Fx delivered weekly is a great option for palliation.This has been used in curative system, as well, but I find it to be particularly helpful in elderly patients or those with travel issues. There is a phase 2 study in patients who are medically inoperable and the local con...
Answer from: Radiation Oncologist at Academic Institution
If metastatic, standard palliative doses are fine. I'm not sure of 21 Gy in 3 fx as a 'standard' palliative dose, however.
If not metastatic and you think some, non-zero chance of getting to definitive treatment, QUAD-SHOT 14.8 Gy in 4 fx BID has been great at getting bleeding to cease. Most seem t...
Answer from: Radiation Oncologist at Academic Institution
Prospective evidence for 7 Gy x 3 (or 3.5 Gy x 10) comes from BA09: Duchesne et al., PMID 10802363.QuadShot originated with RTOG 8502, which treated advanced pelvic malignancies to 3 cycles. No difference was seen in outcomes or toxicity between q2 week vs q4 week interval between cycles. I am not a...