Radiochemotherapy With Cisplatin and 5-Fluorouracil After Transurethral Surgery in Patients With Bladder Cancer

Weiß, Christian; Engehausen, Dirk G.; Krause, F; Papadopoulos, Thomas; Dunst, Jürgen; Sauer, Rolf; Rödel, Claus

doi:10.1016/j.ijrobp.2007.01.054

Cited by 86 publications

(53 citation statements)

References 20 publications

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“…In contemporary series, 5-and 10-year overall survival for radical cystectomy is reported between 45% to 60% and 37% to 45%, respectively [2][3][4][5][6][7]. The 5-year overall survival for bladder preservation using trimodality therapy falls within a similar range at 36-74% [25,[27][28][29]33,36,37,[46][47][48][49][50]. Currently, bladder preservation appears to be a viable alternative to radical cystectomy in patients who may be poor surgical candidates or in those who may opt not to undergo radical cystectomy.…”

Section: Discussionmentioning

confidence: 98%

“…These numbers dropped to 21% and 18% for non-responding patients who were treated with immediate radical cystectomy. In patients undergoing TURBT with cisplatin and 5-FU based chemotherapy and radiation, a 5-year overall survival rate of 74%, with 82% of surviving patients maintaining their bladder was observed [29]. These improved outcomes may be secondary to the choice of chemotherapy, but may also be due to stricter selection criteria for those entering the trial.…”

Section: Pol Scientificmentioning

confidence: 99%

“…The Erlangen group has reported lower rates of toxicity. In their review of 415 patients, 3-13% experienced grade 3 toxicity, 0-3% had grade 4 toxicity, and there was 1 treatment related death [29]. Efstathiou reported late grade 3+ pelvic toxicity occurring more than 6 months after chemoradiation in patients enrolled in various RTOG protocols (RTOG 8903, 9506, 9706, 9906) to be 7% [38].…”

Section: Toxicitymentioning

confidence: 99%

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Bladder preservation in the treatment of muscle-invasive bladder cancer

Prado

Gollapudi

King

et al. 2014

Bladder

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Organ preserving strategies are being increasingly utilized in the treatment of solid malignancies with the intent of reducing surgical morbidity and maintaining quality of life. Organ preservation becomes a viable approach only when cancer outcomes are not compromised when compared to radical resection. We reviewed the current literature on bladder preservation for muscle-invasive bladder cancer, focusing on trimodality therapy consisting of complete transurethral resection, radiation therapy, and chemotherapy. Acknowledging the absence of randomized clinical trials, differences in patient selection, and variation in study protocols, trimodality therapy may yield similar 5-and 10-year overall survival rates compared to radical cystectomy alone. This includes the approximately 30% of patients who enter a bladder preservation protocol and undergo salvage radical cystectomy for failure of local control. Currently, bladder preservation appears to be an alternative to radical cystectomy in select patients who have appropriate rigorous surveillance.

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Section: Discussionmentioning

confidence: 98%

Section: Pol Scientificmentioning

confidence: 99%

Section: Toxicitymentioning

confidence: 99%

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Bladder preservation in the treatment of muscle-invasive bladder cancer

Prado

Gollapudi

King

et al. 2014

Bladder

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“…However, Weiss et al (12) suggested that TURB followed by radiochemotherapy could be an alternative treatment for high-risk tumors (T1, G3). In view of the satisfactory results obtained with TURB and BCG, the use of RT in this context is rarely justified and therefore, should be considered only in an individual basis.…”

Section: Radiotherapy For Superficial Cancermentioning

confidence: 99%

The role of radiotherapy in urinary bladder cancer: current status

et al. 2012

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“…Trimodality therapy consisting of radical transurethral resection, chemotherapy and radiation therapy has been attempted as an alternative approach for patients who require cystectomy. Data from multiple institutional and cooperative group studies have shown that this approach is safe and effective, yielding a complete response (CR) in more than 60% of cases (9)(10)(11)(12)(13)(14)(15). However, prospective protocols conducted by the Radiation Therapy Oncology Group (RTOG) demonstrated a survival rate similar to that for radical cystectomy; none of the protocols achieved a 5-year survival rate of more than 60% (9-13).…”

Section: Introductionmentioning

confidence: 99%

Novel bladder preservation therapy for locally invasive bladder cancer: Combined therapy using balloon-occluded arterial infusion of anticancer agent and hemodialysis with concurrent radiation

Azuma

Inamoto²,

Ibuki³

et al. 2010

Int J Oncol

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Abstract.We investigated the effect of balloon-occluded arterial infusion (BOAI) of anticancer agent (cisplatin/gemcitabine), used concomitantly with hemodialysis, which delivers an extremely high concentration of anticancer agent to the site of a tumor without systemic adverse effects, along with concurrent radiation (referred to as the OMC-regimen) in patients with advanced bladder cancer. One hundred and ninety-two patients were assigned to receive either the OMCregimen (n=96) or total cystectomy (n=96). Patients in the OMC-regimen group who failed to achieve CR underwent cystectomy, or secondary BOAI with an increased amount of CDDP or gemcitabine (1600 mg). The OMC-regimen allowed >89% (69/77) of patients with locally invasive tumors to achieve CR [>70% (70/96) of all patients including those with T4 and N(+) disease]. Most (68/69) of the CR patients were still alive with no evidence of recurrence after a mean follow-up of 161 (range 12-805) weeks. The 5-and 15-year overall survival rates were 91.5 and 81.3% (vs. 59.8% and 40.1% for cystectomy, P<0.0001), respectively. No patients suffered Grade III or more severe toxicities. In contrast, at 5 and 15 years after surgery in the total cystectomy group, about 50 and 60% of patients had suffered disease progression or had died, respectively. The OMC-regimen, a new bladderpreservation strategy for patients with locally invasive bladder cancer, can be curative not only in patients for whom cystectomy is indicated, but also in patients whose condition is not amenable to curative treatment and for whom merely palliative therapy would otherwise seem the only option.

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Radiochemotherapy With Cisplatin and 5-Fluorouracil After Transurethral Surgery in Patients With Bladder Cancer

Cited by 86 publications

References 20 publications

Bladder preservation in the treatment of muscle-invasive bladder cancer

Bladder preservation in the treatment of muscle-invasive bladder cancer

The role of radiotherapy in urinary bladder cancer: current status

Novel bladder preservation therapy for locally invasive bladder cancer: Combined therapy using balloon-occluded arterial infusion of anticancer agent and hemodialysis with concurrent radiation

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