[Bladder preservation by chemoradiotherapy in combination with radical TUR-Bt in muscle invasive bladder cancer].
OBJECTIVE
To evaluate bladder preservation protocol by radical TUR-Bt and subsequent concurrent chemoradiotherapy in muscle invasive bladder cancer.


METHODS
Twenty-six patients with muscle invasive bladder cancer (T2-T4NOM0) were treated with concurrent chemoradiotherapy after transurethral resection of the tumor as much as possible beyond muscle layers. Chemotherapy was consisted of systemic administration of methoterexete (30 mg/m2 day 1 and day 22) and intraarterial infusion of cisplatin (70 mg/m2, day 2 and day 23). The response was evaluated by TUR, urine cytology, CT and/or MRI 4 to 6 weeks after the treatment.


RESULTS
Among 24 evaluable cases, pathological complete response was achieved in 13 cases (50%) and residual tumors were noted in 11 cases (pT1 in 9 and pT2 in 2). During follow-up period up to 69.8 months, invasive recurrence was observed in 2 cases, superficial recurrence was noted in 5 patients and distant metastasis without evidence of local recurrence was noted in 4 cases. Overall bladder preservation rate was 92%.


CONCLUSIONS
The bladder preservation by radical TUR-Bt and chemoradiotherapy is a safe and effective treatment option for muscle invasive bladder cancer.
Ishioka
Jun-Ichiro
J
Department of Urology, Saitama Cancer Center, Japan.
Kageyama
Yukio
Y
Ichiyanagi
Nobutaka
N
Saito
Yoshihiro
Y
Nozu
Satoshi
S
Nishida
Kazunori
K
Fukuda
Hiroshi
H
Higashi
Yotsuo
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009132:Muscles / Q000473:pathology; D009361:Neoplasm Invasiveness; D015996:Survival Rate; D020728:Transurethral Resection of Prostate / Q000295:instrumentation; D001743:Urinary Bladder / Q000503:physiopathology; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*
D002945:Cisplatin; D008727:Methotrexate