loading page

BLADDER FUNCTION AFTER CONSERVATIVE SURGERY AND HIGH-DOSE-RATE BRACHYTHERAPY FOR BLADDER-PROSTATE RHABDOMYOSARCOMA.
  • +6
  • Sara Lobo,
  • Mark Gaze,
  • Olga Slater,
  • Peter Hoskin,
  • Gordon Sands,
  • Tracy Sullivan,
  • Alexander Cho,
  • Gemma Eminowicz,
  • Naima Smeulders
Sara Lobo
Great Ormond Street Hospital For Children NHS Foundation Trust

Corresponding Author:[email protected]

Author Profile
Mark Gaze
University College London Hospitals NHS Foundation Trust
Author Profile
Olga Slater
Great Ormond Street Hospital For Children NHS Trust
Author Profile
Peter Hoskin
University College London Hospitals NHS Foundation Trust
Author Profile
Gordon Sands
University College London Hospitals NHS Foundation Trust
Author Profile
Tracy Sullivan
University College London Hospitals NHS Foundation Trust
Author Profile
Alexander Cho
Great Ormond Street Hospital For Children NHS Foundation Trust
Author Profile
Gemma Eminowicz
University College London Hospitals NHS Foundation Trust
Author Profile
Naima Smeulders
Great Ormond Street Hospital For Children NHS Foundation Trust
Author Profile

Abstract

Background: Conservative-surgery (CS) brachytherapy (BT) techniques for local therapy in bladder-prostate rhabdomyosarcoma (BP-RMS) seeks to retain organ function. We report bladder function after high-dose-rate (HDR) BT combined with targeted CS for any vesical component of BP-RMS. Procedure: Prospective cohort of all BP-RMS patients between 2014-19 receiving HDR-BT (Iridium-192, 27.5Gy in 5 fractions) with/without percutaneous endoscopic-polypectomy (PEP) or partial cystectomy (PC). Functional assessment included frequency-volume-chart, voided volumes, post-void residual, flow studies, continence status and ultrasound scanning; abnormalities triggered video-urodynamics. Results: Thirteen patients (10 male), aged 9 months to 4 years (median 23 months), presented with localised fusion-negative embryonal BP-RMS measuring 23-140mm (median 43mm) in cranio-caudal extent. After induction chemotherapy, local treatment consisted of PC+BT in three, PEP+BT in four and BT alone in six. At a median 3½ years (range 1¾-7 years) follow up, all were alive without relapse. At a median age of 6 years (4-9 years), the median bladder capacity was 86% (47%-144%) of that expected for age, including 75% (74-114%) after PC. There was no relation to radiation dose to the bladder. Complications occurred in two: one urethral stricture and one vesical decompensation in a patient with pre-existing high-grade VUR. The remaining patients are dry by day; five with anticholinergic medication for urinary urgency. Three patients are enuretic. Conclusions: Day-time dryness at a median 3½ years after CS-HDR-BT was achieved in 92%, with 85% voiding urethrally, and 62% attaining day-and-night continence aged 4-9 years. We report reduced open surgery, with minimally-invasive percutaneous surgery with HDR-BT or brachytherapy alone being suitable for many.
30 Jun 2021Submission Checks Completed
30 Jun 2021Assigned to Editor
30 Jun 2021Submitted to Pediatric Blood & Cancer
01 Jul 2021Reviewer(s) Assigned
22 Jul 2021Review(s) Completed, Editorial Evaluation Pending
23 Jul 2021Editorial Decision: Revise Major
24 Aug 2021Assigned to Editor
24 Aug 2021Submission Checks Completed
24 Aug 20211st Revision Received
25 Aug 2021Reviewer(s) Assigned
11 Oct 2021Review(s) Completed, Editorial Evaluation Pending
11 Oct 2021Editorial Decision: Revise Minor
30 Nov 2021Submission Checks Completed
30 Nov 2021Assigned to Editor
30 Nov 20212nd Revision Received
03 Jan 2022Review(s) Completed, Editorial Evaluation Pending
03 Jan 2022Editorial Decision: Accept
Aug 2022Published in Pediatric Blood & Cancer volume 69 issue 8. 10.1002/pbc.29574