[Modern chemotherapy of invasive bladder cancer].
OBJECTIVE
to identify the place and role of modern chemotherapy in invasive bladder cancer.


METHODS
overview of the important data of papers presented in the last three years.


RESULTS
Cisplatin-based chemotherapy with methotrexate-vinblastine-doxorubicin-cisplatin (M-VAC) or gemcitabine-cisplatin (GC) is the standard treatment and prolongs survival in metastatic disease. The paclitaxel-gemcitabine-cisplatin (TGC) protocol did not change standard therapy. Neoadjuvant chemotherapy before cystectomy for T2-3 disease provides a survival benefit compared with surgery alone. Adjuvant chemotherapy is less compelling, however, it is used in case of locally advanced, extravesical and/or lymph node-positive disease. The identification of patient's risk factors helps the decision of individual treatment strategy.


CONCLUSIONS
Better understanding of molecular mechanisms and carcinogenetic pathways of bladder cancer and combination of old and new drugs with targeted therapy may increase the effectiveness of treatment in bladder cancer.
Géczi
Lajos
L
Országos Onkológiai Intézet, Kemoterápia C és Klinikai Farmakológiai Osztály, Budapest. gelajos@oncol.hu
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004317:Doxorubicin / Q000008:administration & dosage; D006801:Humans; D008207:Lymphatic Metastasis; D008727:Methotrexate / Q000008:administration & dosage; D020360:Neoadjuvant Therapy / Q000379:methods; D009361:Neoplasm Invasiveness; D017239:Paclitaxel / Q000008:administration & dosage; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D014747:Vinblastine / Q000008:administration & dosage; D000093542:Gemcitabine
D003841:Deoxycytidine; D014747:Vinblastine; D004317:Doxorubicin; D017239:Paclitaxel; D002945:Cisplatin; D008727:Methotrexate; D000093542:Gemcitabine