
carcinoma of bladder: cobalt therapy
from 1959 to 1962, 202 patients have received
radiotherapy for carcinoma of the bladder.  radi-
cal therapy with cobalt-60 has been done in 121
of these cases.  these patients received tumor
doses in excess of 5000 rad in 3 weeks.  of 49 pa-
tients followed for 2 years after radical treatment,
28 are alive.  sixteen out of 32 patients with
stage b2, c or d tumors are alive; while 15 pa-
tients survived out of 30 with tumors of grades
3 and 4 (broders').  four of the 28 survivors had
cystectomy performed and none showed residual
disease in the bladder or lymph nodes.  the com-
plications of radiotherapy presented were not
considered to be excessive.
we believe that radiotherapy should be the
initial treatment for patients with infiltrative
carcinoma of the bladder.  the survivals pre-
sented at 2 years are better than those quoted for
radical cystectomy (whitmore and marshall)
and useful bladder function is preserved for the
majority of survivors.  we reserve cystectomy for
specific indications.
