Clinical Outcomes and Prognosis Analyses of Late-line Elderly Patients with Advanced Bladder Cancer and Hematuria receiving Radiotherapy

With the intensification of population aging, the number of elderly cancer patients has increased dramatically in recent years. However, the treatment of aged cancer patients, particularly those who are not eligible for surgery, is still a challenge. Thus, in this study, we retrospectively summarized and analyzed the clinical effects of radiotherapy in 43 late-line patients with advanced bladder cancer, with an average age of 77.3 ± 5.1 years. All patients were pathologically diagnosed with transitional epithelial carcinoma of the bladder, persistent bleeding, no condition for surgery, and were not suitable for chemotherapy. After thorough communication, all patients were treated with radiotherapy. As a result, the degree of bleeding gradually decreased after 5 rounds of 10Gy radiotherapy. After 15 rounds of 30Gy radiotherapy, the gross hematuria disappeared, and the success rate of radiotherapy in preventing bleeding reached 100%. At the end of follow-up, 24 patients passed away, and 19 patients were alive. The median survival time (OS) was 14 months. Statistical analysis revealed that the survival time of patients significantly differed between radical and palliative radiotherapy. The survival time of patients with advanced cancer is usually less than 3 months in the clinic, whereas the OS of patients (14 months) in this study far exceeded that reported previously. Therefore, radiotherapy can not only stop bleeding and relieve symptoms but also prolong patient survival time, offering an option for elderly patients with advanced bladder cancer to control tumor progression and improve quality of life.