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Abstract Bladder cancer is the foremost oncologic problem in Egypt, accountirtg for approximately 20% of all malignancies and constituting about 32% of male cancers and 5% of female cancers. Considering the pathological features and natural history of the disease, radical cystectomy provides the logical treatment for most of the resectable cases specially in bilharzial bladder cancer. In a critical analysis of the causes of treatment failure, most of the recurrences were largely local indicating that radical cystectomy alone was insufficient to control the local neoplasm in some cases. Preoperative radiotherapy to the pelvis may improve the end results after cystectomy. The present double armed prospective randomized study included 52 cases with invasive squamous cell carcinoma of bladder (stage T2 and T3), with negative lymph node involvement and with no evidence of distant metastases who were amenable for surgery. The study compared preoperative radiotherapy with cystectomy alone Group I entitled 21 cases who received preoperative radiotherapy (40Gy/4 weeks/20 fractions using 3 or 4 fields box using supervoltage machine) followed 4 weeks later by cystectomy and group II entitled 31 cases who underwent radical cystectomy alone. |