title: Radiotherapy concurrent with weekly gemcitabine after transurethral tumor resection in muscle ınvasive bladder cancer.
abstract: OBJECTIVE
  In this report, we determined the efficacy and the toxicity of low dose weekly gemcitabine with radiotherapy, in medically unfit or refused surgery muscle-invasive bladder cancer (BC) patients.
  
  
  METHODS
  From 2008 to 2012, 15 patients were included into the retrospective analysis. Weekly gemcitabine was administered at a rate of 50 mg/m(2) with a median dose of 63 Gy radiotherapy.
  
  
  RESULTS
  The median age was 69 (range, 55-86). Median follow-up was 15 months (range, 5-53 months). A complete response was achieved in 12 patients (80%). Median progression free survival and overall survival were 15 months (range, 7-23 months) and 18 months (range not calculated), respectively. Local recurrence was found in 3 patients (20%) and distant recurrence was found in 5 patients (33.3%) for the entire group. While salvage surgery was performed on 1 patient, salvage chemotherapy was delivered for 4 patients. Treatment was well tolerated, there was no treatment interruption or instances of toxic death. A serious toxicity (grade 3) cystitis was seen in only 1 patient.
  
  
  CONCLUSIONS
  Multimodality treatment of muscle invasive BC proved a feasible and effective treatment option. Gemcitabine based chemoradiation is an active treatment option with a low toxicity profile for patients with muscle invasive BC, who are not suitable medically or refused to surgery.
authors.forename: Umut
authors.initials: U
authors.lastname: Demirci
authors.forename: Omer
authors.initials: O
authors.lastname: Dızdar
authors.forename: M Faik
authors.initials: MF
authors.lastname: Cetindag
authors.forename: Serkan
authors.initials: S
authors.lastname: Altınova
authors.forename: Atiye
authors.initials: A
authors.lastname: Ozsavran
authors.forename: Didem Sener
authors.initials: DS
authors.lastname: Dede
authors.forename: Nurgul
authors.initials: N
authors.lastname: Kızılırmak
authors.forename: F Aysun
authors.initials: FA
authors.lastname: Eraslan
authors.forename: Bulent
authors.initials: B
authors.lastname: Yalcın
authors.affiliation: Department of Medical Oncology, Dr. A.Y. Ankara Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Havva Yesil
authors.initials: HY
authors.lastname: Cinkir
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D015653:Cystectomy; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000473:pathology / Q000628:therapy*; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000628:therapy*; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine