Neoadjuvant therapy for locally invasive bladder cancer: results of randomized trials in 40 patients

The present investigation was conducted to examine the effect of a neoadjuvant cyclophosphamide, doxorubicin and cisplatin (CAP) regimen with radiotherapy for locally invasive bladder cancer as a well-controlled randomized trial. Since 1986, a total of 40 patients with primary transitional cell carcinoma of the urinary bladder have been randomized into two groups: neoadjuvant CAP plus radiation-treated group and control group. Of 18 patients who received neoadjuvant chemotherapy, complete and partial responses were observed in 52.9% of 17 measurable and evaluable patients and downstaging was observed in 92.9% of 14 evaluable patients. The 3-year survival rates of the neoadjuvant-treated and control group were 93.8 and 83.6%, respectively. No statistical significance was achieved in the survival rates. These results indicated that neoadjuvant CAP would be useful in the management of invasive bladder cancer.