Concurrent chemoradiotherapy improves survival outcome in muscle-invasive bladder cancer

Abstract

PurposeTo evaluate survival rates and prognostic factors related to treatment outcomes after bladder preserving therapy including transurethral resection of bladder tumor, radiotherapy (RT) with or without concurrent chemotherapy in bladder cancer with a curative intent.Materials and MethodsWe retrospectively studied 50 bladder cancer patients treated with bladder-preserving therapy at Keimyung University Dongsan Medical Center from January 1999 to December 2010. Age ranged from 46 to 89 years (median, 71.5 years). Bladder cancer was the American Joint Committee on Cancer (AJCC) stage II, III, and IV in 9, 27, and 14 patients, respectively. Thirty patients were treated with concurrent chemoradiotherapy (CCRT) and 20 patients with RT alone. Nine patients received chemotherapy prior to CCRT or RT alone. Radiation was delivered with a four-field box technique (median, 63 Gy; range, 48.6 to 70.2 Gy). The follow-up periods ranged from 2 to 169 months (median, 34 months).ResultsThirty patients (60%) showed complete response and 13 (26%) a partial response. All patients could have their own bladder preserved. Five-year overall survival (OS) rate was 37.2%, and the 5-year disease-free survival (DFS) rate was 30.2%. In multivariate analysis, tumor grade and CCRT were statistically significant in OS.ConclusionTumor grade was a significant prognostic factor related to OS. CCRT is also considered to improve survival outcomes. Further multi-institutional studies are needed to elucidate the impact of RT in bladder cancer.

Comparison of outcomes between trimodal therapy and radical cystectomy in muscle-invasive bladder cancer: a propensity score matching analysis

“…As some patients strongly prefer to retain their own bladders, interest in trimodal therapy (TMT), which combines transurethral resection (TUR) of bladder tumor with radiotherapy (RT), and chemotherapy, is increasingly considered as alternative therapy for MIBC. TMT is the most effective bladder-preserving treatment approach for MIBC [ 1 , 2 ]; however, to date, a prospective randomized trial directly comparing RC and TMT has not been conducted. Several studies showed that overall survival (OS) with TMT was similar to that achieved with RC [ 3 , 4 ].…”

Modern possibilities of organ-preserving treatment of patients with muscle-invasive bladder cancer

“…S.J. Byun et al ретроспективно изучили результаты органосохраняющего лечения 50 пациентов с мышечно-инвазивным РМП (средний возраст -71,5 года): пятилетняя общая выживаемость и раковоспецифическая выживаемость составили 37,2 и 30,2 % соответственно [20]. При многофакторном анализе индекс G оказался статистически значимым показателем прогноза, что позволило представить графическую зависимость (рис.…”

Role of 5‑Aza‑CdR in mitomycin‑C chemosensitivity of T24 bladder cancer cells

“…Approximately 10% of non-invasive bladder cancer cases eventually progress to invasive cancer following the transurethral resection of the bladder tumor (3). Compared with non-invasive bladder cancer, patients with invasive disease have a poor prognosis, with a 5-year survival rate of 50% (4). Systemic chemotherapy remains the major therapeutic option for muscle-invasive bladder cancer in neoadjuvant and adjuvant settings, as well as for metastatic disease.…”