title: Results of concomitant radio-chemotherapy for invasive bladder tumors.
abstract: BACKGROUND
  The aim of this study was to evaluate combined radiation and chemotherapy for invasive bladder tumors and to define possible biological prognostic factors.
  
  
  METHODS
  Forty-five patients (mean age 75 years, range 68 to 86) were treated by deep bladder resection with combined radiation (5 courses of 10 Grays [Gys]) and chemotherapy (2 cycles of 100 mg of cisplatin over 7 weeks). Subsequent to the treatment, evaluations at 10 weeks, then 3 months, 6 months, and 12 months, and every year, included a clinical examination, Karnofsky evaluation, a cystoscopy with urinary cytology, and systematic deep bladder pathology biopsies after a computer tomography (CT) scan. In our series, DNA analysis and an immuno-histochemistry study of MiB1, p53, and MdR were also performed in the last 20 patients.
  
  
  RESULTS
  At 6 months, progression of the disease was evaluated in 26% of cases; at 12 months, satisfactory local control was evaluated in 60% of cases. However, only 15 patients were in complete remission after a period of 2 years. Of these, only eight patients were in remission with more than 42 months follow-up. We observed aneuploid tumors in 30% of cases; these patients died after 6 months despite concomitant radio-chemotherapy. In our experience, the results of associated immuno-histochemistry markers was not really contributive.
  
  
  CONCLUSIONS
  This therapeutic alternative may be useful in patients where a cystectomy cannot be performed. It not only permits bladder conservation, but also offers satisfactory, significant quality of life, even if survival rates remain uncertain.
authors: Urology Department, Rouen University Hospital, France.
authors: C
authors: C
authors: Pfister
authors: F
authors: F
authors: Dunet
authors: J
authors: J
authors: Moussu
authors: A
authors: A
authors: Laquerriere
authors: J F
authors: JF
authors: Heintz
authors: P
authors: P
authors: Grise
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D016019:Survival Analysis; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin