The Treatment of Carcinoma of the Bladder by Supervoltage X Rays

Four hundred and twelve cases of cancer of the bladder treated by supervoltage radiotherapy have been analysed. The treatment policy is discussed in relation to the extent of the tumour, its histological pattern and the probability of its spread in the bladder wall and to the pelvic lymphatic nodes. The techniques of treatment are described. The survival rates are given for the stage of the disease, the histological type, the site of the tumour in the bladder and its cystoscopic appearance. Lesions with extravesical spread to both sides of the pelvis were found to have a worse prognosis than those with a spread to one side. The reactions after treatment and the late complications are described and their incidence related to the tumour dose. The tumour response at different times after treatment has been analysed for the different histological types and the site of the lesion. The results of a small prospective investigation suggest that the disappearance rate does not increase with a higher tumour dose. Possible methods of improving the results are discussed.