title: Concurrent chemoradiotherapy improves survival outcome in muscle-invasive bladder cancer.
abstract: OBJECTIVE
  To evaluate survival rates and prognostic factors related to treatment outcomes after bladder preserving therapy including transurethral resection of bladder tumor, radiotherapy (RT) with or without concurrent chemotherapy in bladder cancer with a curative intent.
  
  
  METHODS
  We retrospectively studied 50 bladder cancer patients treated with bladder-preserving therapy at Keimyung University Dongsan Medical Center from January 1999 to December 2010. Age ranged from 46 to 89 years (median, 71.5 years). Bladder cancer was the American Joint Committee on Cancer (AJCC) stage II, III, and IV in 9, 27, and 14 patients, respectively. Thirty patients were treated with concurrent chemoradiotherapy (CCRT) and 20 patients with RT alone. Nine patients received chemotherapy prior to CCRT or RT alone. Radiation was delivered with a four-field box technique (median, 63 Gy; range, 48.6 to 70.2 Gy). The follow-up periods ranged from 2 to 169 months (median, 34 months).
  
  
  RESULTS
  Thirty patients (60%) showed complete response and 13 (26%) a partial response. All patients could have their own bladder preserved. Five-year overall survival (OS) rate was 37.2%, and the 5-year disease-free survival (DFS) rate was 30.2%. In multivariate analysis, tumor grade and CCRT were statistically significant in OS.
  
  
  CONCLUSIONS
  Tumor grade was a significant prognostic factor related to OS. CCRT is also considered to improve survival outcomes. Further multi-institutional studies are needed to elucidate the impact of RT in bladder cancer.
authors.affiliation: Yongsan Health Subcenter, Jangheung, Korea.
authors.forename: Sang Jun
authors.initials: SJ
authors.lastname: Byun
authors.affiliation: Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Young Kee
authors.initials: YK
authors.lastname: Oh
authors.affiliation: Department of Urology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Byung Hoon
authors.initials: BH
authors.lastname: Kim
keywords: Bladder preservation; Concurrent chemoradiotherapy; Prognostic factor; Radiotherapy; Survival rate; Urinary bladder neoplasm