Combined radiation and chemotherapy for invasive transitional-cell carcinoma of the bladder: a prospective study.

Housset, M.; Maulard, C; Chrétien, Yves; Dufour, B; Delanian, S.; Huart, Judith; Colardelle, Francoise; Brunel, P.; Baillet, F

doi:10.1200/jco.1993.11.11.2150

Cited by 281 publications

(125 citation statements)

References 27 publications

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“…However, insufficient local tumor control has been previously reported using this management approach (8). Many patients unfit for surgery will suffer from ongoing tumor-related symptoms (pain, urgency, hematuria).…”

Section: Discussionmentioning

confidence: 99%

The efficacy of hemostatic radiotherapy for bladder cancer-related hematuria in patients unfit for surgery

et al. 2013

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Objective: The aim of our study was to assess short and mid-term clinical efficacy of external beam radiation therapy to achieve hemostasis in patients with bladder-cancer related gross hematuria who were unfit for surgery. We also assessed hypofractionation as a possible alternative option for more severe patients. Patients and Methods: Thirty-two patients were included for hemostatic radiation therapy, with two schedules based on Eastern Cooperative Oncology Group performance status. The standard treatment was 30 Gy in 10 fractions over 2 weeks. More severe patients underwent a hypofractionated regimen, with 20 Gy in 5 fractions over a one week period. Clinical evaluation was performed at 2 weeks and 6 months. Results: At 2 weeks, 69% of patients were hematuria-free. Subgroup analysis showed that 79% of patients undergoing hypofractionated regimen were hematuria-free. A total of 54% were hematuria-free with the standard regimen. Based on tumor stage, hematuria was controlled at 2 weeks for 57% of non-muscle invasive tumors and 72% of muscle--invasive tumors. After 6 months, 69% of patients had relapsed, regardless of tumor stage or therapy schedules. Conclusions: Hemostatic radiotherapy is an effective option for palliative-care hematuria related to bladder cancer in patients unfit for surgery. Although it appears to be rapidly effective, its effect is of limited duration. Hypofractionation also seems to be an effective option; however larger cohorts and prospective trials are needed to evaluate its efficacy compared to standard schedules.

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Section: Discussionmentioning

confidence: 99%

The efficacy of hemostatic radiotherapy for bladder cancer-related hematuria in patients unfit for surgery

et al. 2013

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“…[47][48][49] Conversely, one series reported that all patients who achieved a CR after radiotherapy (RT) with concurrent cisplatin and 5-FU were pT0 on immediate cystectomy. 50 Although studies report differing frequencies of residual disease after cytotoxic agents (either radiation or chemotherapy), there is consensus that the rate is lower for patients who present with T2 disease versus T3 disease, which should be considered when proposing a bladder-sparing approach.…”

Section: Bladder Preservationmentioning

confidence: 99%

Bladder Cancer, Version 5.2017, NCCN Clinical Practice Guidelines in Oncology

Spiess¹,

Agarwal²,

Bangs³

et al. 2017

J Natl Compr Canc Netw

218

169

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OverviewAn estimated 79,030 new cases of urinary bladder cancer (60,490 men and 18,540 women) will be diagnosed in the United States in 2017 and approximately 16,870 deaths (12,240 men and 4630 women) will occur. Please NoteThe NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines Disclosures for the NCCN Bladder Cancer PanelAt the beginning of each NCCN Guidelines panel meeting, panel members review all potential conflicts of interest. NCCN, in keeping with its commitment to public transparency, publishes these disclosures for panel members, staff, and NCCN itself.Individual disclosures for the NCCN Bladder Cancer Panel members can be found on page 1267 (The most recent version of these guidelines and accompanying disclosures are available on the NCCN Web site at NCCN.org.)These guidelines are also available on the Internet. For the latest update, visit NCCN.org.

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“…5 One of the clearest indications of the potential for chemoradiotherapy came from the University of Paris, where the concurrent chemoradiotherapy approach (as a planned preoperative approach) did not identify any residual disease at cystectomy in the first 18 patients. 6 These results led to a prospective study of selective bladder presentation using a trimodality strategy. 7 The University of Erlangen reported the results of its trimodality treatment in 2002.…”

Section: Bladder Preservationmentioning

confidence: 99%

“…6 These results led to a prospective study of selective bladder presentation using a trimodality strategy. 7 The University of Erlangen reported the results of its trimodality treatment in 2002. 8 In this protocol, patients completed the full course of chemoradiotherapy and underwent transurethral resection of bladder cancer (TURBT) restaging at 6 weeks to 8 weeks and salvage cystectomy for recurrence.…”

Section: Bladder Preservationmentioning

confidence: 99%

“…The overall survival of the modern bladder preserving series at 5 years ranges from 45% to 52% (Table1) and 54% to 67% of surviving patients have a tumour-free normally functioning bladder. 7,[9][10][11][12] Unfortunately, in the absence of a randomized study directly comparing radical cystectomy (with or without chemotherapy) with trimodality treatment, it is not possible to have a definite answer that would guide patient care and inform patients. Differences in patient selection and reporting based on pathologic staging (surgical series) versus clinical staging (bladder-preserving trimodality treatment) makes comparability of results from these treatment approaches difficult.…”

Section: Bladder Preservationmentioning

confidence: 99%

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