In most cases, radiation therapy will only be appropriate to consider
- as palliative therapy
- in combination with surgery and/or chemotherapy, for fixed positive nodes
- at necrotizing tumors where primary surgery alone poses a risk
- if the the tumor is inoperable
In these situations, multimodal treatment is necessary involving an oncologist, pathologist, radiologist, and an urologist.
If the cancer is locally advanced, inoperable, or there are remaining tumor after surgery, radiation therapy is given with the guidance of CT. The pelvic field is irradiated with 50 Gy in 25 fractions and a boost of 14 Gy in 7 fractions to the macrotumor.