Trimodal bladder-preserving treatment including high-tech radiotherapy in invasive bladder carcinoma-dissertation project with literature review

Over the last two decades, there has been a significant evolution of the complex treatment of the invasive bladder carcinoma (BC), including both surgery methods and high-tech radiotherapy (RT), often combined with chemotherapy (Ch). Different protocols supporting multimodal treatment and the concept of the bladder preservation are currently developed. New high-tech radiation methods were presented combined with Ch to preserve the bladder as a healing alternative to radical cystectomy. The purpose of this overview is to present the place and healing effect of high-tech RT in the contemporary treatment approach to invasive BC. The expected contributions from this research project are: 1) For the first time in Bulgaria, modern bladder-sparing strategies combine maximal transurethral resection of bladder tumor (TURBT) followed by an induction course of concurrent radiation therapy (RT) and sensitizing chemotherapy will be held. 2) Disease-free survival, overall survival, local control and early radical toxicity in two patient groups after self intensity modulated radiation therapy (IMRT) and after concurrent chemoradiotherapy (CChRT) with VMAT will be analyzed. It is important to improve the quality of life by preserving the bladder in the invasive bladder carcinoma.