Radiotherapy in localized bladder cancer: what is the evidence?

Purpose of review Bladder-sparing bladder treatments have recently been rejuvenated with the introduction of concomitant chemotherapy usually as part of multimodality therapy including endoscopic resection and radiotherapy. This article reviews recent evidence for the role of radiotherapy in the treatment of localized bladder cancer. Recent findings Several single institution series of multimodality radiochemotherapy have shown consistently fair disease-specific survival and local control in those who show a complete response after endoscopic resection. Developments in radiotherapy fractionation, adaptive planning and chemotherapy delivery are clearly in progress. Summary Much of the evidence is retrospective and involves treating locally advanced poor-risk patients. It would seem right to attempt to prospectively evaluate these treatments for truly localized (T1/2) bladder cancer.