{
  "abstract": "BackgroundUrothelial carcinoma with neuroendocrine differentiation is a rare, yet highly aggressive histological subtype of bladder cancer, characterized by rapid disease progression, poor prognosis, and a tendency to metastasize, with the liver being a common metastatic site. Current treatments involving chemotherapy and immunotherapy have limitations, including poor patient tolerability and the rapid development of drug resistance, particularly in patients exhibiting low PD-L1 expression and those who have failed multiple lines of therapy. Increasing evidence supports the use of low-dose radiotherapy (LDRT) as an immunomodulatory approach that can overcome drug resistance in many patients.Case presentationHerein, we report the case of a 54-year-old male patient with urothelial carcinoma exhibiting partial neuroendocrine differentiation and extensive liver metastases. PD-L1 testing revealed a combined positive score of 1. The patient had developed resistance following first-line chemotherapy and second-line chemoimmunotherapy. As a third-line treatment, he received whole-liver LDRT (WL-LDRT: 5 Gy in 10 fractions), with a simultaneous integrated boost to selected lesions, combined with immunotherapy and chemotherapy. One month post-treatment, imaging demonstrated that the patient had shown a partial response to treatment, athree months later, all the liver metastases were disappeared. Notably, the patient achieved progression-free survival exceeding 9 months.ConclusionTo the best of our knowledge, this is the first case report of a patient with extensive liver metastases from bladder cancer who achieved complete radiological response of the hepatic metastases after overcoming resistance to both chemotherapy and immunotherapy with a combination of WL-LDRT and simultaneous integrated boost. This case highlights a novel and potentially safe salvage strategy for treating similar cases of chemotherapy- and immunotherapy-refractory metastatic bladder cancer, which could help improve the clinical outcomes of patients with this rare but highly aggressive cancer.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "Case Report",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "name": "Changmin Han"
    },
    {
      "name": "Xiongjie Yu"
    },
    {
      "name": "Liguo Gao"
    },
    {
      "name": "Fengjun Cao"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/eef2kvydd3z2n.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1965942",
  "fulltext_url": null,
  "id": "eef2kvydd3z2n",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1965942",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "feed-journal",
      "medicine/oncology"
    ]
  ],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-12",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/eef2kvydd3z2n.ris",
  "sources": [
    {
      "first_seen": "2026-11-12T06:20:42Z",
      "native_id": "10.3389/fonc.2026.1965942",
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      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1965942"
    },
    {
      "first_seen": "2026-11-12T12:23:21Z",
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      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1965942/full"
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  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "feed-journal:medicine/oncology",
      "subfield": "oncology"
    }
  ],
  "title": "Complete radiological response of hepatic metastases from bladder cancer following whole-liver low-dose radiotherapy with simultaneous integrated boost combined with chemoimmunotherapy: a case report",
  "title_text": "Complete radiological response of hepatic metastases from bladder cancer following whole-liver low-dose radiotherapy with simultaneous integrated boost combined with chemoimmunotherapy: a case report",
  "type": "peer-reviewed",
  "updated_at": "2026-11-13T12:20:48Z",
  "url": "https://research.draconitic.com/paper/eef2kvydd3z2n",
  "venue": "Frontiers in Oncology",
  "versions": []
}