Sponsor: University Hospitals Sussex NHS Foundation Trust
Radical surgery has been considered to be the standard of care for patients with muscle invasive bladder cancer, but:-
two recent RCTs have shown radiotherapy with either concurrent chemotherapy or nicotinamide and carbogen are at least as successful (in terms of overall survival) as historical series of patients treated with surgery
a large retrospective study in Leeds (n=458) between 1993 & 1996 found no difference in survival between patients treated with radiotherapy or surgery - with 10 year follow-up data
NICE guidelines acknowledge there is little evidence that one treatment is more effective than the other recommending patients are offered a choice of radical surgery or radiotherapy with a radio-sensitizer
the only randomised trial (SPARE) that attempted a head to head evaluation of surgical outcomes with radical radiotherapy closed early due to poor recruitment and the possibility of another RCT is remote
The aim of the Q-ABC study is to address the current paucity of information available to patients and clinicians facing treatment decisions where increasingly evidence is showing surgery and radiotherapy can provide equivalent overall survival.