title: Concurrent chemoradiotherapy with low dose weekly gemcitabine in medically inoperable muscle-invasive bladder cancer patients.
abstract: OBJECTIVE
  We aimed to determine the efficacy and the toxicity of low dose weekly gemcitabine with radiation therapy in medically unfit muscle-invasive bladder cancer patients.
  
  
  METHODS
  Twenty-six patients were included into the retrospective analysis. Weekly gemcitabine was administered 75 mg/m(2) with a median dose of 63 Gy radiation therapy. Clinical target volume was defined as the urinary bladder only in conformal treatment planning.
  
  
  RESULTS
  Median follow-up was 51 months (range 14-118 months). Complete response rate was 62.5 %. The 5-year local progression-free survival, disease-specific survival and overall survival rates were 40.6, 59.5 and 58.5 %, respectively. Concurrent chemotherapy was continued in 80.7 % of patients without any interruption. Gemcitabine was stopped due to grade 3 thrombocytopenia (n = 1), cardiac angina (n = 1), chronic obstructive pulmonary disease exacerbation (n = 1) or patients' reluctance (n = 2).
  
  
  CONCLUSIONS
  Low dose weekly gemcitabine with concurrent radiotherapy is a tolerable regimen and have comparable outcomes with platinum-based combined treatments in muscle-invasive bladder cancer. Prospective randomized trials can help in understanding the safety and efficacy of this treatment specially in medically unfit patients.
authors.affiliation: Department of Radiation Oncology, Marmara University School of Medicine, Istanbul, Turkey, bmatasoy@yahoo.com.
authors.forename: B M
authors.initials: BM
authors.lastname: Atasoy
authors.forename: F
authors.initials: F
authors.lastname: Dane
authors.forename: I
authors.initials: I
authors.lastname: Alsan Cetin
authors.forename: Z
authors.initials: Z
authors.lastname: Ozgen
authors.forename: A
authors.initials: A
authors.lastname: Ucuncu Kefeli
authors.forename: R
authors.initials: R
authors.lastname: Ibrahimov
authors.forename: N S
authors.initials: NS
authors.lastname: Turhal
authors.forename: U
authors.initials: U
authors.lastname: Abacioglu
authors.forename: L
authors.initials: L
authors.lastname: Turkeri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D002295:Carcinoma, Transitional Cell / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000628:therapy*; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine