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Cancers
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Innovations and Current Evidence in Radiotherapy for Urological Cancers
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Innovations and Current Evidence in Radiotherapy for Urological Cancers

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 30 November 2026 | Viewed by 1657

Special Issue Editor

Dr. Tomoyuki Makino

E-Mail Website
Guest Editor
Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
Interests: prostate cancer; kidney cancer; brachytherapy

Special Issue Information

Dear Colleagues,

Radiation therapy plays an essential and continually expanding role in the management of urological cancers, including prostate, kidney, urothelial, testicular, and penile malignancies. Recent advances in imaging, treatment planning, and delivery have enabled highly conformal dose increases, improved organ preservation, and optimized toxicity profiles. Furthermore, the integration of stereotactic body radiotherapy, image-guided adaptive techniques, particle therapy, and brachytherapy has expanded the therapeutic window for both localized and metastatic disease. Accumulating evidence supports the utility of metastasis-directed therapy, salvage radiotherapy strategies after local failure, and palliative regimens tailored to disease biology and patient-specific risk. In parallel, emerging biomarkers, radiogenomic approaches, and immuno-radiotherapy combinations are redefining precision oncology for urological tumors.

This Special Issue will present current clinical and translational research that reflects recent developments in this field. We welcome original investigations, balanced reviews, and multidisciplinary studies examining emerging treatment approaches, technological improvements, potential predictive markers, and contemporary outcomes. By gathering contributions spanning the range of urological oncology, this Special Issue will provide an updated overview of evidence informing radiation therapy and support continued refinement of strategies that enhance disease control, functional preservation, and patient-centered care.

Dr. Tomoyuki Makino
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • radiotherapy
  • urological cancer
  • prostate cancer
  • kidney cancer
  • urothelial cancer
  • testicular cancer
  • penile cancer
  • palliative
  • metastases
  • salvage

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Published Papers (2 papers)

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Research

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13 pages, 833 KB  
Article
High-Dose-Rate Brachytherapy Combined with External Beam Radiotherapy for Newly Defined Very High-Risk and Regional Prostate Cancer: A 17-Year Single-Institution Experience
by Tomoyuki Makino, Takayuki Sakurai, Shigeyuki Takamatsu, Ryunosuke Nakagawa, Taiki Kamijima, Hiroshi Kano, Renato Naito, Hiroaki Iwamoto, Hiroshi Yaegashi, Kazuyoshi Shigehara, Takahiro Nohara, Kouji Izumi and Atsushi Mizokami
Cancers 2026, 18(4), 595; https://doi.org/10.3390/cancers18040595 - 11 Feb 2026
Viewed by 671
Abstract
Background: The updated National Comprehensive Cancer Network (NCCN) criteria redefine the very high-risk (VHR) prostate cancer (PC) category, identifying patients with highly aggressive disease. Evidence regarding the outcomes of high-dose-rate brachytherapy (HDR-BT) in these patients, including those with regional disease, is limited. [...] Read more.
Background: The updated National Comprehensive Cancer Network (NCCN) criteria redefine the very high-risk (VHR) prostate cancer (PC) category, identifying patients with highly aggressive disease. Evidence regarding the outcomes of high-dose-rate brachytherapy (HDR-BT) in these patients, including those with regional disease, is limited. Therefore, the present study focused on analyzing the long-term clinical performance of HDR-BT-based radiotherapy (RT) for patients meeting the NCCN criteria for VHR or regional PC. Methods: A total of 215 patients with VHR (n = 179) or regional disease (n = 36) treated with HDR-BT with external beam RT between 2006 and 2022 were retrospectively reviewed. Recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were assessed using Kaplan–Meier methods, and prognostic factors were analyzed using Cox regression. Results: Recurrence occurred in 19 (8.8%) patients, and 22 (10.2%) died, including 4 PC-specific deaths. The 5-year RFS, CSS, and OS rates were 92.5%, 98.9%, and 96.2%, respectively, and the 8-year rates were 88.5%, 97.8%, and 90.8%, respectively. Multivariate analysis revealed that pre-RT prostate-specific antigen (PSA) > 0.1 ng/mL (HR 3.93; p = 0.010) and cT4 disease (HR 4.49; p = 0.032) were independent predictors of inferior RFS. Grade ≥ 3 genitourinary toxicity was observed in 1.9% of patients, and no Grade ≥ 3 gastrointestinal toxicity occurred. Conclusions: HDR-BT-based RT provides durable disease control and low toxicity in patients with NCCN-defined VHR and regional PC. Pre-RT PSA and T stage may inform risk-adapted treatment strategies. The present findings demonstrate the importance of HDR-BT as an effective component of multimodal therapy for highly aggressive PC. Full article
(This article belongs to the Special Issue Innovations and Current Evidence in Radiotherapy for Urological Cancers)
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Review

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20 pages, 933 KB  
Review
Bladder Preservation with Concurrent Chemoradiotherapy Following Complete Response to Induction Systemic Therapy in Patients with Muscle-Invasive Bladder Cancer: A Review of the Existing Literature
by Georgios Nikiforos Ntoumas, Andromachi Kougioumtzopoulou, Dimitra Desse, Charalambos Fragkoulis, Georgios Papadopoulos, Efthymios Kostouros, Dimitra Michaletou, Vassileios Kouloulias, Anna Zygogianni and Ioannis Georgakopoulos
Cancers 2026, 18(6), 961; https://doi.org/10.3390/cancers18060961 - 16 Mar 2026
Viewed by 716
Abstract
Background/Objectives: The standard surgical treatment of muscle-invasive bladder cancer (MIBC) comprises neoadjuvant systemic therapy followed by radical cystectomy (RC). However, a notable number of patients achieve a favorable response to neoadjuvant systemic therapy, a finding associated with improved outcomes, and questioning the necessity [...] Read more.
Background/Objectives: The standard surgical treatment of muscle-invasive bladder cancer (MIBC) comprises neoadjuvant systemic therapy followed by radical cystectomy (RC). However, a notable number of patients achieve a favorable response to neoadjuvant systemic therapy, a finding associated with improved outcomes, and questioning the necessity of RC in this subset of patients. The objective of this review is to summarize the available evidence regarding the feasibility, efficacy and toxicity of bladder-preserving chemoradiotherapy (CRT) following clinical response (CR) to neoadjuvant systemic therapy in patients with MIBC. Methods: A literature search was performed using the PubMed database to identify studies evaluating the use of CRT for bladder preservation in MIBC patients with CR following neoadjuvant therapy. Results: Clinical complete response (cCR) rates to neoadjuvant systemic treatment ranged from 31% to 87.5%, with subsequent CRT enabling 50–97% of responders to retain their bladder. Long-term outcomes were favorable for cCR patients, with 3- to 5-year overall survival (OS) ranging from 65% to 89%, disease-free survival (DFS) of 64–86%, and bladder-intact survival up to 80%. Achievement of cCR, T2 tumor stage, absence of concomitant carcinoma in situ or hydronephrosis, and complete transurethral resection of the bladder tumor (TURBT) were prognostic factors for improved oncologic outcomes. Treatment-related toxicity was generally acceptable, concerning mainly hematological and gastrointestinal events, while severe late toxicity was uncommon. Conclusions: Bladder-preserving CRT is a promising, effective, and well-tolerated option for MIBC patients achieving CR to neoadjuvant systemic therapy. While further prospective validation and longer follow-up are required before it can universally replace radical cystectomy in this subset of patients, advances in neoadjuvant treatments, imaging and molecular biomarkers may improve response assessment and patient selection for bladder preservation. Full article
(This article belongs to the Special Issue Innovations and Current Evidence in Radiotherapy for Urological Cancers)
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