Top Line: Pelvic recurrence of bladder cancer can cause significant morbidity even if distant disease is a main driver of mortality.
The Study: Results from the BART trial recently showed that adjuvant RT for high risk disease improved locoregional control without significantly increasing grade 3+ toxicity. Bladder-ART is a phase 2 trial that randomized 80 patients with pT3a-4b, pN1-2, or positive margin bladder cancer following radical cystectomy to pelvic radiation (50.4 Gy in 28 fractions) or observation. Most patients (62.2%) received adjuvant chemotherapy. This report takes a look at initial toxicity outcomes. The rate of acute grade 2+ GI toxicity was significantly higher after RT (28.8% v 4.5%). Acute grade 3+ events happened in 3.8% v 0%, however there were no acute grade 3+ GI events attributable to RT. Acute grade 2+ GU events were actually numerically higher in the observation arm. These findings are similar to those of the toxicity outcomes of BART showing that the locoregional control benefits of adjuvant RT may be worth the mild and transient GI toxicity.
TBL: Adjuvant pelvic radiation for bladder cancer causes mild, transient GI toxicity without significantly increasing the risk of serious adverse events. | Sargos, Radiother Oncol 2025
The Study: Results from the BART trial recently showed that adjuvant RT for high risk disease improved locoregional control without significantly increasing grade 3+ toxicity. Bladder-ART is a phase 2 trial that randomized 80 patients with pT3a-4b, pN1-2, or positive margin bladder cancer following radical cystectomy to pelvic radiation (50.4 Gy in 28 fractions) or observation. Most patients (62.2%) received adjuvant chemotherapy. This report takes a look at initial toxicity outcomes. The rate of acute grade 2+ GI toxicity was significantly higher after RT (28.8% v 4.5%). Acute grade 3+ events happened in 3.8% v 0%, however there were no acute grade 3+ GI events attributable to RT. Acute grade 2+ GU events were actually numerically higher in the observation arm. These findings are similar to those of the toxicity outcomes of BART showing that the locoregional control benefits of adjuvant RT may be worth the mild and transient GI toxicity.
TBL: Adjuvant pelvic radiation for bladder cancer causes mild, transient GI toxicity without significantly increasing the risk of serious adverse events. | Sargos, Radiother Oncol 2025