Hammer L, et al. - Authors assessed 17 patients with a median age of 87 years to analyze the treatment results of definitive image-guided accelerated hypofractionated radiation therapy in cases of muscle-invasive bladder cancer (unsuitable for surgery or trimodality treatment). About 94% of cases completed the therapy with a median time of 20 days. They observed 69% of complete local response at 3-month cystoscopy. They noted distant metastases development in two candidates and local recurrence in six. Overall survival at 1 year and 2 years was 47% and 23%, respectively, and cancer-specific survival at 1 and 2 years were 85% and 63%, respectively, and 6% and 24% had incidents of acute grade 3 gastrointestinal or genitourinary toxicities, respectively. Contemporary radiation techniques such as volumetric modulated arc therapy were associated with reduced bowel toxicity compared with 3-dimensional conformal radiotherapy.