Chemoradiotherapy in locally advanced bladder carcinoma

Bladder carcinoma represents the fifth leading cause of cancer in the United States. For patients with muscle-invasive tumors, radical cystectomy has been the treatment of choice, yet over 50% of such treated patients are destined to develop recurrent disease. In order to minimize morbidity in patients with invasive disease, bladder-sparing techniques using radiotherapy alone, or with chemotherapy, have been investigated. While it is clear that durable complete remission can be achieved in some patients, the results to date require additional follow-up to determine the optimal cohort of patients destined to benefit from this approach. It is hoped that ongoing prospective trials will delineate this population.