Phase I/II trial of preoperative thermoradiotherapy in the treatment of urinary bladder cancer.
Between April 1984 and September 1988, preoperative radiotherapy or thermoradiotherapy was administered to 49 patients with bladder cancer (T1-4N0M0; UICC classification, 1987). Twenty-one patients were preoperatively treated by radiotherapy alone, with 4 Gy per fraction and three fractions per week to a total dose of 24 Gy (TDF = 53, group 1). The other 28 patients were treated by the same radiotherapy regimen in combination with hyperthermia (group 2). Regional hyperthermia was administered for 35-60 min immediately after irradiation (two sessions per week to a total of four sessions) using an 8 MHz RF capacitive heating device. Group 2 was divided into group 2 (high), in which the average intravesical temperature (T(av)) was > 41.5 degrees C, which was the mean value, and group 2 (low) with a T(av) < 41 x 5 degrees C. Group 2 (high) showed a significantly higher incidence of down-staging and tumour degeneration than both group 1 and group 2 (low). In addition, the local recurrence rate was lower and survival time was longer in group 2 than in group 1, although not significantly so. In particular, the patients with T3-4 or grade 3 bladder cancer in group 2 had a longer average survival than those in group 1, although the difference was not significant. The toxicity associated with hyperthermia was pain during treatment, and complications were not serious.
Masunaga
S I
SI
Radiation Oncology Research Laboratory, Kyoto University, Osaka, Japan.
Hiraoka
M
M
Akuta
K
K
Nishimura
Y
Y
Nagata
Y
Y
Jo
S
S
Takahashi
M
M
Abe
M
M
Terachi
T
T
Oishi
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000532:radiotherapy* / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011379:Prognosis; D001749:Urinary Bladder Neoplasms / Q000532:radiotherapy* / Q000601:surgery / Q000628:therapy*