External beam radiotherapy (EBRT), as part of a trimodality approach, is an attractive bladder-preserving alternative to radical cystectomy. Several EBRT regimens with different treatment volumes have been described with similar tumour control and, so far, clear recommendations on the optimal radiotherapy regimen and treatment volume are lacking. The current review summarises EBRT literature on dose prescription, fractionation as well as treatment volume in order to guide clinicians in their daily practice when treating patients with muscle-invasive bladder cancer. Taking into account literature on repopulation, continuous-course radiotherapy can be used safely in daily practice where a split-course should only be reserved for those patients who are fit enough to undergo a radical cystectomy in case of a poor early response. A recent meta-analysis has proven that hypofractionated radiotherapy is superior to conventional radiotherapy with regards to invasive locoregional control with similar toxicity profiles. In the absence of node-positive disease, the target volume can be restricted to the bladder. In order to compensate for organ motion, very large margins need to be applied in the absence of image-guided radiotherapy (IGRT). Therefore, the use of IGRT or an adaptive approach is recommended. Based on the available literature, one can conclude that moderate hypofractionated radiotherapy to a dose of 55 Gy in 20 fractions to the bladder only, delivered with IGRT, can be considered standard of care for patients with node-negative invasive bladder cancer.

作为三联疗法的一部分，外照射放疗 (EBRT) 是一种有吸引力的膀胱保留替代疗法，可替代根治性膀胱切除术。已经描述了几种具有不同治疗量的 EBRT 方案具有相似的肿瘤控制，但到目前为止，缺乏关于最佳放疗方案和治疗量的明确建议。本综述总结了关于剂量处方、分次和治疗量的 EBRT 文献，以指导临床医生在治疗肌肉浸润性膀胱癌患者时的日常实践。考虑到关于重新填充的文献，连续疗程放疗可以安全地用于日常实践，其中分期放疗只应保留给那些身体足够健康，可以在早期反应不佳的情况下进行根治性膀胱切除术的患者。最近的一项荟萃​​分析证明，在具有相似毒性特征的侵入性局部控制方面，大分割放疗优于传统放疗。在没有淋巴结阳性疾病的情况下，目标体积可以限制在膀胱内。为了补偿器官运动，在没有图像引导放疗 (IGRT) 的情况下需要应用非常大的边缘。因此，建议使用 IGRT 或自适应方法。根据现有文献，可以得出结论，中等大分割放疗剂量为 55 Gy，仅对膀胱进行 20 次分割，并通过 IGRT 进行，可被视为淋巴结阴性浸润性膀胱癌患者的标准治疗。