How do you approach a patient with inoperable urothelial carcinoma of the bladder with persistent non-muscle invasive disease despite intravesical BCG/IFN and intravesical chemotherapy?

Would you recommend radiation and/or systemic therapy? If you would irradiate, what would your fields/volumes look like?

Answer from: Radiation Oncologist at Academic Institution

T1 high grade urothelial carcinoma, with persistent disease after intra-vesicular therapy (e.g., BCG) is an aggressive disease and progression to invasive urothelial cancer is common. This entity tends to be multifocal / diffuse and transurethral resection (TURBT) alone is often inadequate as defini...

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Medical Oncologist at University of Washington School of Medicine
Great answer by the excellent @Omar Y. Mian. The S...

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How do you approach a patient with inoperable urothelial carcinoma of the bladder with persistent non-muscle invasive disease despite intravesical BCG/IFN and intravesical chemotherapy?

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