title: Trimodality therapy in bladder cancer: who, what, and when?
abstract: Radical cystectomy is a standard treatment of nonmetastatic, muscle-invasive bladder cancer. Treatment with trimodality therapy consisting of maximal transurethral resection of the bladder tumor followed by concurrent chemotherapy and radiation has emerged as a method to preserve the native bladder in highly motivated patients. Several factors can affect the likelihood of long-term bladder preservation after trimodality therapy and therefore should be taken into account when selecting patients. New radiation techniques such as intensity modulated radiation therapy and image-guided radiation therapy may decrease the toxicity of radiotherapy in this setting. Novel chemotherapy regimens may improve response rates and minimize toxicity.
authors.affiliation: Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, 10 CRC, B2-3500, Bethesda, MD 20892, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Premo
authors.affiliation: Bladder Cancer Section, Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 10 Center Drive 12N226, MSC 1906, Bethesda, MD 20892, USA.
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Apolo
authors.affiliation: Bladder Cancer Section, Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Building 10, Room 2W-5940, Bethesda, MD 20892-1210, USA.
authors.forename: Piyush K
authors.initials: PK
authors.lastname: Agarwal
authors.affiliation: Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, 10 CRC, B2-3500, Bethesda, MD 20892, USA. Electronic address: citrind@mail.nih.gov.
authors.forename: Deborah E
authors.initials: DE
authors.lastname: Citrin
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D057189:Checklist; D003131:Combined Modality Therapy / Q000379:methods; D015653:Cystectomy; D006801:Humans; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods; D018579:Patient Selection; D061089:Radiotherapy, Image-Guided; D050397:Radiotherapy, Intensity-Modulated; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents
keywords: Bladder preservation; Chemoradiation; Muscle-invasive bladder cancer; Radiation; Urothelial carcinoma of the bladder